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Organization
CONCORD PREMIUM GROUP
Active
Organization
CONCORD PREMIUM GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL W THOMPSON (CEO)
(801) 300-5159
Entity
Organization
Contact information
Practice address
356 N 750 W, STE D9-213, AMERICAN FORK, UT 84003-1678
(801) 300-5159
Mailing address
356 N 750 W, STE D9-213, AMERICAN FORK, UT 84003-1678
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3713101205
UT
Other
Enumeration date
09/24/2009
Last updated
10/16/2009
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