Organization
BEAR RIVER HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEE JOHNSON (TREASURER)
(208) 401-1369
Entity
Organization
Contact information
Practice address
1153 N MAIN ST STE B100, LOGAN, UT 84341-2573
(435) 752-2291
(435) 213-2230
Mailing address
1153 N MAIN ST STE B100, LOGAN, UT 84341-2573
(435) 752-2291
(435) 213-2230
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
06/14/2022
Last updated
06/14/2022
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