Organization
CACHE VALLEY CANCER TREATMENT &RESEARCH CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALI BEN-JACOB M.D. (DOCTOR)
(435) 752-5999
Entity
Organization
Contact information
Practice address
1281 N 600 E, LOGAN, UT 84341-6988
(435) 752-5999
(435) 752-5551
Mailing address
1281 N 600 E, LOGAN, UT 84341-6988
(435) 752-5999
(435) 752-5551
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
292373-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1427187582
GROUP NATIONAL PROVIDER IDENTIFIER
UT
Enumeration date
03/05/2007
Last updated
11/03/2014
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