Organization
ADVANCED INTEGRATED MEDICAL LLC
Active
Other names
Advanced Integrated Medical, Advanced Integrated Medical of Cache Valley
Organization subpart
No
Provider details
NPI number
Authorized official
DEE S STEVENS DC (MEMBER)
(435) 764-1775
Entity
Organization
Contact information
Practice address
1635 N 200 E, LOGAN, UT 84341-1913
(435) 932-6138
(435) 213-9325
Mailing address
1635 N 200 E, LOGAN, UT 84341-1913
(435) 932-6138
(435) 213-9325
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1962456681
OTHER INSURERS
UT
Enumeration date
06/04/2020
Last updated
06/29/2020
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