Advantage Medical Center LLC
Family Medicine in Brigham City, UT. Organization (NPI-2).
NPI number1053861567
StatusActive
Last updated in NPPESDec 1, 2016
Details
- NPI
- 1053861567
- Entity type
- Organization (NPI-2)
- Legal business name
- Advantage Medical Center LLC
- Organization subpart
- No
- Enumeration date
- Oct 7, 2016
- Last updated
- Dec 1, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
| 111N00000X | Chiropractor | 5118842-0160 | UT | |
| 363L00000X | Nurse Practitioner | 189510-4405 | UT |
Practice location
770 S 200 ESte 102
Brigham City, UT 84302
Phone 435-723-0517 · Fax 435-723-0587
Mailing address
770 S 200 ESte 102
Brigham City, UT 84302
Phone 435-723-0517 · Fax 435-723-0587
Authorized official
Jeremiah Hoopes
Chiropractor
4357230517
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