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Organization
EVERGREEN MEDICAL, INC.
Active
Organization
EVERGREEN MEDICAL, INC.
Active
Other names
the SMART Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MARCI A MERRILL (BILLING MANAGER)
(801) 676-7627
Entity
Organization
Contact information
Practice address
96 E KIMBALLS LN STE 304, DRAPER, UT 84020-5021
(801) 676-7627
(801) 676-7629
Mailing address
PO BOX 900280, SANDY, UT 84090-0280
(801) 676-7627
(801) 676-7629
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
208VP0014X
Interventional Pain Medicine Physician
—
NULL
208VP0014X
Interventional Pain Medicine Physician
—
—
Other
Enumeration date
04/10/2007
Last updated
07/24/2023
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