Organization
IHC HEALTH SERVICES INC
Active
Other names
Utah Valley Urology Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK BRIESACHER MD (CHIEF PHYS EXEC AND PRES MED GROUP)
(801) 442-3495
Entity
Organization
Contact information
Practice address
395 W COUGAR BLVD STE 704, PROVO, UT 84604-3333
(801) 357-3242
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 357-3242
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Enumeration date
07/03/2017
Last updated
01/14/2021
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