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Organization

HIDDEN VALLEY FAMILY MEDICINE INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DANI LASSITER (PRACTICE ADMINISTRATOR)
(801) 572-3750
Entity
Organization

Contact information

Practice address
12176 S 1000 E, DRAPER, UT 84020-9716
(801) 572-3750
(801) 572-1097
Mailing address
12176 S 1000 E STE 4, DRAPER, UT 84020-3221
(801) 572-3750
(801) 572-1097

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
181191-8905
UT
207Q00000X
Family Medicine Physician
181268-1205
UT
207Q00000X
Family Medicine Physician
Primary
188509-1205
UT

Other

Enumeration date
07/14/2006
Last updated
05/08/2024
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