Healthcare Provider Details

I. General information

NPI: 1063358307
Provider Name (Legal Business Name): FIRST CARE MEDICAL-ORTHOMED LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 W SCENIC POINTE DR STE 102
DRAPER UT
84020-6124
US

IV. Provider business mailing address

2168 W GROVE PKWY STE 200
PLEASANT GROVE UT
84062-6748
US

V. Phone/Fax

Practice location:
  • Phone: 385-213-6443
  • Fax: 801-609-7090
Mailing address:
  • Phone: 385-365-5053
  • Fax: 385-365-5054

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NATE D MILLER
Title or Position: PRESIDENT
Credential: DC
Phone: 801-899-2053