Organization
HEALTH CLINICS OF UTAH
Active
Other names
State of Utah
Organization subpart
No
Provider details
NPI number
Authorized official
MISS STACEY MARIE KEYES CPC (HEALTH PROGRAM REPRESENTATIVE-BILLE)
(801) 626-3353
Entity
Organization
Contact information
Practice address
150 E. CENTER ST., #1100, PROVO, UT 84606
(801) 374-7011
(801) 374-7009
Mailing address
150 E CENTER ST., #1100, PROVO, UT 84606
(801) 374-7011
(801) 374-7009
Taxonomy
Speciality
Code
Description
License number
State
261QP0905X
State or Local Public Health Clinic/Center
105991-1206
UT
261QP0905X
State or Local Public Health Clinic/Center
Primary
1610961205
UT
261QP0905X
State or Local Public Health Clinic/Center
285456-4405
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05664
—
UT
05
—
05665
—
UT
05
—
535501136001
—
UT
Enumeration date
04/20/2006
Last updated
05/18/2012
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