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Organization

ASHLEY VALLEY PHYSICIAN PRACTICE, LLC

Active
Other names
Roosevelt Community Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
CHARLOTTE LAWRENCE (SECRETARY)
(615) 920-7000
Entity
Organization

Contact information

Practice address
409 S 200 E, ROOSEVELT, UT 84066-3314
(435) 725-3327
(435) 725-3331
Mailing address
409 S 200 E, ROOSEVELT, UT 84066-3314
(435) 725-3327
(435) 725-3331

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Enumeration date
08/19/2011
Last updated
09/18/2024
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