Organization
IHC HEALTH SERVICES INC
Active
Other names
Utah Valley Rock Canyon Pediatric Specialists
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK BRIESACHER M.D. (SVP-CHIEF PHYSICIAN EXEC PRES IMG)
(801) 442-3495
Entity
Organization
Contact information
Practice address
395 W COUGAR BLVD STE 702, PROVO, UT 84604-3333
(801) 357-1700
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 357-1700
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
8432010
UT
2080P0206X
Pediatric Gastroenterology Physician
Primary
8432010
UT
Other
Enumeration date
06/23/2010
Last updated
05/08/2022
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