Healthcare Provider Details
I. General information
NPI: 1619666906
Provider Name (Legal Business Name): IHC HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/03/2023
Last Update Date: 01/31/2024
Certification Date: 01/31/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
900 ROUND VALLEY DR
PARK CITY UT
84060-7552
US
IV. Provider business mailing address
PO BOX 27128
SALT LAKE CITY UT
84127-0128
US
V. Phone/Fax
- Phone: 435-333-3535
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RS0010X |
| Taxonomy | Sports Medicine (Internal Medicine) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JP
VALIN
Title or Position: CHIEF CLINICAL OFFICER
Credential: MD
Phone: 801-442-2000