Organization
SEVIER VALLEY MEDICAL CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KERRY A BLACKHAM M.D. (MD/OWNER)
(435) 529-4243
Entity
Organization
Contact information
Practice address
131 E MAIN ST, SUITE 3, SALINA, UT 84654-1335
(435) 529-4243
(435) 529-4239
Mailing address
131 NORTH MAIN STREET, SUITE 3, SALINA, UT 84654-1107
(435) 529-4243
(435) 529-4239
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3715201204
UT
Other
Enumeration date
08/16/2011
Last updated
08/16/2011
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