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Organization
VIVINT MEDICAL CLINIC
Active
Organization
VIVINT MEDICAL CLINIC
Active
Parent organization
FUTURA MEDICAL CLINIC
Other names
Vivint Medical Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
FUTURA MEDICAL CLINIC
Authorized official
DARCE LATSIS (OPERATIONS MANAGER)
(801) 705-8040
Entity
Organization
Contact information
Practice address
4907 NORTH 300 WEST, PROVO, UT 84604-8460
(801) 705-8040
(801) 765-5740
Mailing address
560 S 300 E STE 275, SALT LAKE CITY, UT 84111-3586
(801) 441-1002
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
10/05/2017
Last updated
01/30/2020
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