Organization
RIVERSIDE MEDICAL CENTER LLC
Active
Other names
Blue Rock Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
BARBARA GIVENS (OFFICE MANAGER)
(801) 229-2002
Entity
Organization
Contact information
Practice address
3152 N UNIVERSITY AVE STE 100, PROVO, UT 84604-4729
(801) 229-2002
(801) 229-1003
Mailing address
3152 N UNIVERSITY AVE STE 100, PROVO, UT 84604-4729
(801) 229-2002
(801) 229-1003
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
06/29/2011
Last updated
11/01/2012
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