Organization
STELLAR PCP LLC
Active
Other names
Ovation Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
MATHEW HARRISON (CFO)
(817) 941-1068
Entity
Organization
Contact information
Practice address
800 E FORT UNION BLVD STE B, MIDVALE, UT 84047-2391
(801) 694-1198
Mailing address
800 E FORT UNION BLVD STE B, MIDVALE, UT 84047-2391
(801) 694-1198
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
03/10/2023
Last updated
12/20/2024
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