Organization
SUNRISE FAMILY PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOLOLENE ALLAN APRN (OWNER)
(385) 645-7474
Entity
Organization
Contact information
Practice address
8785 S JORDAN VALLEY WAY # 100, WEST JORDAN, UT 84088-9772
(385) 645-7474
Mailing address
8785 S JORDAN VALLEY WAY # 100, WEST JORDAN, UT 84088-9772
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
211972-4405
UT
Other
Enumeration date
05/22/2018
Last updated
02/14/2019
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