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Organization

ATLAS MEDICAL UTAH LLC

Active
Other names
Sentry Medical
Organization subpart
No

Provider details

NPI number
Authorized official
GREGORY CHAD MANGUM (OWNER)
(435) 383-6120
Entity
Organization

Contact information

Practice address
258 S MAIN ST STE 210, LOGAN, UT 84321-5768
(435) 383-6120
(435) 557-8003
Mailing address
PO BOX 86, PROVIDENCE, UT 84332-0086
(435) 383-6120
(435) 557-8003

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary

Other

Enumeration date
02/19/2019
Last updated
09/26/2025
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