# VIVINT MEDICAL CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** FUTURA MEDICAL CLINIC
- **Other names:** Vivint Medical Clinic
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1265942163
- **Legal business name:** FUTURA MEDICAL CLINIC
- **Authorized official:** DARCE LATSIS (OPERATIONS MANAGER)
- **Authorized official phone:** (801) 705-8040

## Contact information

- **Practice address:** 4907 NORTH 300 WEST, PROVO, UT 84604-8460
- **Practice address phone:** (801) 705-8040
- **Practice address fax:** (801) 765-5740
- **Mailing address:** 560 S 300 E STE 275, SALT LAKE CITY, UT 84111-3586
- **Mailing address phone:** (801) 441-1002

## Taxonomy

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

## Other

- **Enumeration date:** 10/05/2017
- **Last updated:** 01/30/2020