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Organization

CEDAR VALLEY FAMILY & FOOT LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LYNSEY NIELSEN (CLINICAL ADMINISTRATOR)
(385) 388-8003
Entity
Organization

Contact information

Practice address
3435 E PONY EXPRESS PKWY STE 140, EAGLE MOUNTAIN, UT 84005-5548
(801) 789-2444
(801) 789-2045
Mailing address
3435 E PONY EXPRESS PKWY STE 140, EAGLE MOUNTAIN, UT 84005-5548
(385) 388-8003

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
207RI0011X
Interventional Cardiology Physician
213ES0103X
Foot & Ankle Surgery Podiatrist
213ES0131X
Foot Surgery Podiatrist
Primary
363LF0000X
Family Nurse Practitioner

Other

Enumeration date
06/29/2022
Last updated
08/22/2023
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