Healthcare Provider Details

I. General information

NPI: 1942506290
Provider Name (Legal Business Name): CLINICAL METHODS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2011
Last Update Date: 02/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

676 E VINE ST STE 5
MURRAY UT
84107-5514
US

IV. Provider business mailing address

676 E VINE ST STE 5
MURRAY UT
84107-5514
US

V. Phone/Fax

Practice location:
  • Phone: 801-290-5320
  • Fax: 801-290-5321
Mailing address:
  • Phone: 801-290-5320
  • Fax: 801-290-5321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number StateUT

VIII. Authorized Official

Name: DR. REID JUSTIN ROBISON
Title or Position: PARTNER
Credential: M.D., M.B.A.
Phone: 801-230-5899