Organization
STAT-MD II
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN KNEPPER (OWNER)
(435) 604-0160
Entity
Organization
Contact information
Practice address
7724 S 5600 W STE 102, WEST JORDAN, UT 84081-5415
(801) 432-8480
(435) 604-0160
Mailing address
7724 S 5600 W STE 102, WEST JORDAN, UT 84081-5415
(801) 432-8480
(435) 604-0160
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
10/01/2019
Last updated
10/01/2019
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