Organization
BLUEROCK MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTHA HODGES (BILLING MANAGER)
(801) 437-4895
Entity
Organization
Contact information
Practice address
3152 N UNIVERSITY AVE, SUITE 130, PROVO, UT 84604-4745
(801) 437-4895
(801) 229-1003
Mailing address
3152 N UNIVERSITY AVE, SUITE 130, PROVO, UT 84604-4745
(801) 437-4895
(801) 229-1003
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
07/09/2013
Last updated
07/09/2013
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