Organization
GLACIER PEAK PAIN CARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIRSTEN E BACA MD (MEMBER)
(443) 413-3130
Entity
Organization
Contact information
Practice address
1407 N 2000 W, CLINTON, UT 84015-8562
(385) 333-7123
Mailing address
1407 N 2000 W, CLINTON, UT 84015-8562
(385) 333-7123
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
9777824-1205
UT
Other
Enumeration date
01/25/2017
Last updated
05/06/2025
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