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Organization

ADVANCED FAMILY MEDICINE, LLC

Active
Parent organization
ADVANCED FAMILY MEDICINE, LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
ADVANCED FAMILY MEDICINE, LLC
Authorized official
ROGER A RUSSELL DC (CLINIC ADMINISTRATOR)
(435) 656-0234
Entity
Organization

Contact information

Practice address
619 S BLUFF ST, TOWER 1 SUITE 100, ST GEORGE, UT 84770-3853
(435) 656-0234
(435) 656-2622
Mailing address
619 S BLUFF ST, TOWER 1 SUITE 100, ST GEORGE, UT 84770-3853
(435) 656-0234
(435) 656-2622

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Enumeration date
08/28/2015
Last updated
08/28/2015
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