Healthcare Provider Details

I. General information

NPI: 1821558024
Provider Name (Legal Business Name): MILLCREEK MEDICAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2019
Last Update Date: 01/03/2025
Certification Date: 01/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5526 S VAN WINKLE EXPY
MURRAY UT
84117-7324
US

IV. Provider business mailing address

5526 S VAN WINKLE EXPY
MURRAY UT
84117-7324
US

V. Phone/Fax

Practice location:
  • Phone: 480-532-9176
  • Fax: 801-716-3532
Mailing address:
  • Phone: 480-532-9176
  • Fax: 801-716-3532

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JEFFREY CHARLES SCHRAMM
Title or Position: OWNER
Credential:
Phone: 801-989-4645