Organization
ASHLEY VALLEY FAMILY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAUN C SHURTLIFF DO (PRESIDENT)
(435) 781-8899
Entity
Organization
Contact information
Practice address
872 W HIGHWAY 40, VERNAL, UT 84078-2416
(435) 781-8899
(435) 781-8898
Mailing address
872 W HIGHWAY 40, VERNAL, UT 84078-2416
(435) 781-8899
(435) 781-8898
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07/16/1967
OWNER'S BIRTHDATE
—
Enumeration date
10/26/2006
Last updated
10/28/2020
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