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Organization

VIVINT MEDICAL CLINIC

Active
Parent organization
FUTURA MEDICAL CLINIC
Other names
Vivint Medical Clinic
Organization subpart
Yes

Provider details

NPI number
Legal business name
FUTURA MEDICAL CLINIC
Authorized official
DARCE LATSIS (OPERATIONS MANAGER)
(801) 705-8040
Entity
Organization

Contact information

Practice address
4907 NORTH 300 WEST, PROVO, UT 84604-8460
(801) 705-8040
(801) 765-5740
Mailing address
560 S 300 E STE 275, SALT LAKE CITY, UT 84111-3586
(801) 441-1002

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Enumeration date
10/05/2017
Last updated
01/30/2020
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