Organization
CENTERVILLE MEDICAL CENTER
Active
Parent organization
CENTERVILLE MEDICAL CENTER
Other names
Maplewood Medical
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTERVILLE MEDICAL CENTER
Authorized official
DR. ROBERT E PARK D.C. (CEO)
(801) 298-7330
Entity
Organization
Contact information
Practice address
6783 S REDWOOD RD, SUITE 104, WEST JORDAN, UT 84084-5677
(801) 268-2929
(801) 268-0198
Mailing address
6783 S REDWOOD RD STE 104, WEST JORDAN, UT 84084-5686
(801) 298-7330
(801) 295-5434
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
UT
Other
Enumeration date
09/28/2012
Last updated
02/27/2014
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