Organization
JORDAN LANDING FAMILY MEDICINE LLC
Active
Other names
Jordan Landing Clinic LLC
Organization subpart
No
Provider details
NPI number
Authorized official
BRENTEN CLARK PUGH (CEO)
(801) 280-7774
Entity
Organization
Contact information
Practice address
3895 W 7800 S SUITE 100, WEST JORDAN, UT 84088-1966
(801) 280-7774
Mailing address
3895 W 7800 S SUITE 100, WEST JORDAN, UT 84088-1966
(801) 280-7774
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
50540301205
UT
Other
Enumeration date
06/14/2007
Last updated
09/25/2019
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