MEDICARE: SNP MEDICAL HOLDINGS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1689346298
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SNP MEDICAL HOLDINGS LLC

Provider Business Mailing Address
First Line	:	6699 S 1300 E
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84121-7239
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6699 S 1300 E
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84121-7239
Country	:	US
Telephone Number	:	612-244-8260
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SEAN FILSON
Credential	:
Telephone Number	:	612-244-8260

Provider Enumeration Date	:	10/01/2021
Last Update Date	:	10/06/2021

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Directions to “SNP MEDICAL HOLDINGS LLC ” Practice Location

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