# STELLAR PCP LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ovation Primary Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144921867
- **Authorized official:** MATHEW HARRISON (CFO)
- **Authorized official phone:** (817) 941-1068

## Contact information

- **Practice address:** 800 E FORT UNION BLVD STE B, MIDVALE, UT 84047-2391
- **Practice address phone:** (801) 694-1198
- **Mailing address:** 800 E FORT UNION BLVD STE B, MIDVALE, UT 84047-2391
- **Mailing address phone:** (801) 694-1198

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/10/2023
- **Last updated:** 12/20/2024