Organization
ADVANCED HEALTH CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA A LARSON L.M.T. (OFFICE MANAGER)
(801) 447-8680
Entity
Organization
Contact information
Practice address
630 SHEPARD LN, FARMINGTON, UT 84025-3934
(801) 447-8680
(801) 447-4211
Mailing address
630 SHEPARD LN, FARMINGTON, UT 84025-3934
(801) 447-8680
(801) 447-4211
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
04/24/2007
Last updated
07/22/2009
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