# COTTONTREE FAMILY PRACTICE

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407036189
- **Authorized official:** SHAUNA MANHART (MANAGER)
- **Authorized official phone:** (801) 377-3413

## Contact information

- **Practice address:** 2230 N UNIVERSITY PKWY, SUITE 1A, PROVO, UT 84604-1509
- **Practice address phone:** (801) 377-3413
- **Practice address fax:** (801) 655-1890
- **Mailing address:** 2230 N UNIVERSITY PKWY, SUITE 1A, PROVO, UT 84604-1509
- **Mailing address phone:** (801) 377-3413
- **Mailing address fax:** (801) 655-1890

## Taxonomy

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

## Other

- **Enumeration date:** 11/09/2007
- **Last updated:** 09/05/2013