Healthcare Provider Details

I. General information

NPI: 1437488319
Provider Name (Legal Business Name): UTAH VALLEY URGENT CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2009
Last Update Date: 08/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 E MAIN ST E
LEHI UT
84043-2288
US

IV. Provider business mailing address

127 E MAIN ST SUITE E
LEHI UT
84043-2288
US

V. Phone/Fax

Practice location:
  • Phone: 801-766-9822
  • Fax:
Mailing address:
  • Phone: 801-766-9822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0000X
TaxonomyAdolescent Medicine (Family Medicine) Physician
License Number7526271-1204
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number7526271-1204
License Number StateUT
# 3
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number7526271-1204
License Number StateUT
# 4
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number StateUT

VIII. Authorized Official

Name: BRYAN ADAMS
Title or Position: OWNER
Credential: NP
Phone: 801-766-9822