Organization
MOUNTAIN WEST FAMILY PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BLAKE BEAZER MD (PRESIDENT)
(435) 882-2350
Entity
Organization
Contact information
Practice address
2356 N 400 E, SUITE 201, TOOELE, UT 84074
(435) 882-2350
(435) 882-2039
Mailing address
2356 N 400 E, SUITE 201, TOOELE, UT 84074
(435) 882-2350
(435) 882-2039
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2005172
UT
Other
Enumeration date
07/13/2005
Last updated
11/24/2020
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