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Organization

PASSPORT HEALTH HOLDINGS, LLC

Active
Other names
Passport Health
Organization subpart
No

Provider details

NPI number
Authorized official
MR. PAUL FISHBURN (CHIEF OPERATING OFFICER)
(480) 646-9020
Entity
Organization

Contact information

Practice address
563 W 500 SOUTH, SUITE 215, BOUNTIFUL, UT 84010-8172
(877) 358-8648
(877) 877-6875
Mailing address
668 N 44TH ST, SUITE 100W, PHOENIX, AZ 85008-6507
(877) 358-8648
(877) 877-6875

Taxonomy

Speciality
Code
Description
License number
State
2083P0901X
Public Health & General Preventive Medicine Physician
Primary

Other

Enumeration date
03/26/2019
Last updated
04/01/2022
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