# LIVING TREE MEDICAL GROUP

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

## Provider details

- **NPI number:** 1639754583
- **Authorized official:** KRIS COLEMAN (COC)
- **Authorized official phone:** (435) 770-2131

## Contact information

- **Practice address:** 1635 N 200 E, LOGAN, UT 84341-1913
- **Practice address phone:** (435) 565-6043
- **Practice address fax:** (435) 215-4420
- **Mailing address:** 1635 N 200 E, LOGAN, UT 84341-1913
- **Mailing address phone:** (435) 565-6043
- **Mailing address fax:** (435) 220-2030

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 261QH0100X | Health Service Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 03/12/2021
- **Last updated:** 07/11/2025