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Organization

INDEPENDENCE PHYSICIAN AND RESOURCE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DANIEL FRASURE (MANAGING PARTNER)
(801) 698-8927
Entity
Organization

Contact information

Practice address
640 S 500 W, BOUNTIFUL, UT 84010-7210
(801) 298-1100
(801) 298-1988
Mailing address
640 S 500 W, BOUNTIFUL, UT 84010-7210
(801) 298-1100
(801) 298-1988

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
208D00000X
General Practice Physician
Primary

Other

Enumeration date
03/26/2015
Last updated
04/03/2015
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