# MTC MEDICAL, LLC

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

## Provider details

- **NPI number:** 1720759236
- **Authorized official:** GABE UTLEY (FINANCE DIRECTOR)
- **Authorized official phone:** (801) 693-2918

## Contact information

- **Practice address:** 500 N MARKET PLACE DR STE 100, CENTERVILLE, UT 84014-1711
- **Practice address phone:** (801) 693-2918
- **Mailing address:** 500 N MARKET PLACE DR STE 100, CENTERVILLE, UT 84014-1711
- **Mailing address phone:** (801) 693-2918

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | — |
| 261QP2400X | Prison Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/23/2021
- **Last updated:** 09/23/2021