Organization · NPI-2
Perry Family Medicine LLC
Clinic/Center · Brigham City, UT
NPI number1558653501
StatusActive
Last updated in NPPESMar 21, 2014
Details
- NPI
- 1558653501
- Entity type
- Organization (NPI-2)
- Legal business name
- Perry Family Medicine LLC
- Organization subpart
- No
- Enumeration date
- May 10, 2011
- Last updated
- Mar 21, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | 277575-4405 | UT | Yes |
Practice location
1030 Medical DrSuite A
Brigham City, UT 84302-3050
Phone 435-723-4500 · Fax 435-723-4504
Mailing address
1030 Medical DrSuite A
Brigham City, UT 84302-3050
Phone 435-723-4500 · Fax 435-723-4504
Authorized official
Cynthia Lynn Duncan
Provider/Owner
8016684860
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