Organization
MAPLE MOUNTAIN MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL JOHNSON (CEO)
(332) 330-3903
Entity
Organization
Contact information
Practice address
724 S 1600 W, MAPLETON, UT 84664-4347
(801) 515-6048
(855) 848-5748
Mailing address
724 S 1600 W, MAPLETON, UT 84664-4347
(801) 515-6048
(855) 848-5748
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
07/17/2024
Last updated
07/17/2024
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