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General NPI Number Information
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NPI Number | 1235526088
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Entity Type | Organization
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Legal Business Name | LONE PEAK MEDICAL ASSOCIATES PLLC
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Dates
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Enumeration Date | 04/20/2015
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Last Update Date | 04/20/2015
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Provider Practice Location Address
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Address Line | 14768 S DRYBURG CV
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City | DRAPER
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State | UT
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Zip | 84020-5673
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Country | US
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Telephone | 801-558-5126
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Fax | 801-206-3823
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Provider Business Mailing Address
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Address Line | 14768 S DRYBURG CV
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City | DRAPER
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State | UT
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Zip | 84020-5673
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Country | US
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Telephone | 801-558-5126
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Fax | 801-206-3823
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Authorized Official
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Title or Position | MD/OWNER
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Name | THOMAS R CHRISTENSEN
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Credential | MD
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Telephone | 801-558-5126
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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