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Organization
SHADOW MOUNTAIN FAMILY MEDICINE LLC
Active
Organization
SHADOW MOUNTAIN FAMILY MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID J. KANE (VP)
(801) 568-5999
Entity
Organization
Contact information
Practice address
3855 W 7800 S, SUITE 100, WEST JORDAN, UT 84088-5560
(801) 282-5952
(801) 282-5951
Mailing address
3855 W 7800 S, SUITE 100, WEST JORDAN, UT 84088-5560
(801) 282-5952
(801) 282-5951
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
08/05/2008
Last updated
06/04/2009
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