Organization
ASHLEY VALLEY PHYSICIAN PRACTICE, LLC
Active
Other names
Petar M. Ilievski, MD
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLOTTE LAWRENCE (SECRETARY)
(615) 920-7000
Entity
Organization
Contact information
Practice address
150 W 100 N, VERNAL, UT 84078-2036
(435) 381-4511
Mailing address
150 W 100 N, VERNAL, UT 84078-2036
(435) 381-4511
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
7161419-8017
UT
Other
Enumeration date
04/13/2009
Last updated
09/18/2024
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