Organization
TREEHOUSE ACORN PEDIATRICS & FAMILY CARE
Active
Other names
Treehouse Pediatrics & Family Care
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MIRANDA OVERY BRYAN (PRACTICE MANAGER)
(435) 799-9101
Entity
Organization
Contact information
Practice address
1325 N 600 E STE 101, LOGAN, UT 84341-6743
(435) 213-3970
(435) 355-3746
Mailing address
1325 N 600 E STE 101, LOGAN, UT 84341-6743
(435) 213-3970
(435) 355-3746
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
528112320001
—
UT
Enumeration date
03/18/2021
Last updated
11/16/2022
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