Organization
UPRI RIVERTON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIE NGOC NGUYEN (CFO)
(801) 281-0555
Entity
Organization
Contact information
Practice address
13322 S 3600 W, SUITE 104, RIVERTON, UT 84065-8024
(801) 466-7246
(801) 281-0444
Mailing address
32 W WINCHESTER ST, SUITE 100, MURRAY, UT 84107-5607
(801) 281-0555
(801) 281-0444
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
7112893-1204
UT
Other
Enumeration date
12/08/2014
Last updated
12/08/2014
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