Organization
RIVERSIDE MEDICAL CENTER LLC
Active
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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