Organization
LONE PEAK PRIMARY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID J KANE (VP)
(801) 568-5999
Entity
Organization
Contact information
Practice address
10011 CENTENNIAL PKWY, SUITE 150, SANDY, UT 84070-4156
(801) 545-8480
(801) 545-8495
Mailing address
10011 CENTENNIAL PKWY, SUITE 150, SANDY, UT 84070-4156
(801) 545-8480
(801) 545-8495
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447360383
—
UT
Enumeration date
08/30/2006
Last updated
03/24/2008
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