Healthcare Provider Details

I. General information

NPI: 1568721496
Provider Name (Legal Business Name): COMPREHENSIVE MEDICAL SERVICES JORDAN HEALTH AND WELLNESS CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2012
Last Update Date: 07/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

677 W 5300 S
MURRAY UT
84123-5671
US

IV. Provider business mailing address

677 W 5300 S
MURRAY UT
84123-5671
US

V. Phone/Fax

Practice location:
  • Phone: 801-327-8700
  • Fax: 844-848-7926
Mailing address:
  • Phone: 801-327-8700
  • Fax: 844-848-7926

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number2621351205
License Number StateUT

VIII. Authorized Official

Name: DR. BRYAN W TURNER
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 801-327-8700