# ALTA MEDICAL SERVICES PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ALTA MEDICAL CLINIC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740348556
- **Authorized official:** DR. KENNETH P LIBRE MD (PRESIDENT)
- **Authorized official phone:** (801) 742-2273

## Contact information

- **Practice address:** 10160 E HIGHWAY 210, ALTA, UT 84092-8072
- **Practice address phone:** (801) 742-2273
- **Practice address fax:** (888) 549-0494
- **Mailing address:** PO BOX 8072, ALTA, UT 84092-8072
- **Mailing address phone:** (801) 742-2273
- **Mailing address fax:** (888) 549-0494

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QU0200X | Urgent Care Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 12/05/2006
- **Last updated:** 05/01/2013