Organization
COTTONTREE FAMILY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAUNA MANHART (MANAGER)
(801) 377-3413
Entity
Organization
Contact information
Practice address
2230 N UNIVERSITY PKWY, SUITE 1A, PROVO, UT 84604-1509
(801) 377-3413
(801) 655-1890
Mailing address
2230 N UNIVERSITY PKWY, SUITE 1A, PROVO, UT 84604-1509
(801) 377-3413
(801) 655-1890
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407036189
—
UT
Enumeration date
11/09/2007
Last updated
09/05/2013
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