Organization
JORDAN RIDGE FAMILY MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMILY CASTILLO (MANAGER)
(702) 480-2550
Entity
Organization
Contact information
Practice address
1403 EAST SEGO LANE, SUITE 100, SANDY, UT 84092
(385) 274-3959
(385) 274-3970
Mailing address
PO BOX 35380, LAS VEGAS, NV 89133-5380
(702) 579-3253
Taxonomy
Speciality
Code
Description
License number
State
261QR0207X
Mobile Mammography Clinic/Center
Primary
—
—
Other
Enumeration date
04/21/2021
Last updated
10/28/2022
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