# THYROID CLINIC LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003493933
- **Authorized official:** LAURA JOHN (CREDENTIALING)
- **Authorized official phone:** (801) 231-6986

## Contact information

- **Practice address:** 1055 N 300 W STE 315, PROVO, UT 84604-3373
- **Practice address phone:** (385) 205-6510
- **Practice address fax:** (385) 375-6112
- **Mailing address:** 4465 S 900 E STE 200, SALT LAKE CITY, UT 84124-2695
- **Mailing address phone:** (385) 205-6510
- **Mailing address fax:** (385) 375-6112

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | NULL | Yes |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/26/2021
- **Last updated:** 01/25/2022