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General NPI Number Information
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NPI Number | 1649745506
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Entity Type | Organization
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Legal Business Name | CONCEPTIONS FAMILY BUILDING ASSOCIATES, PLLC
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Dates
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Enumeration Date | 10/08/2018
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Last Update Date | 10/25/2018
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Provider Practice Location Address
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Address Line | 2435 W 450 S STE 103
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City | PLEASANT GROVE
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State | UT
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Zip | 84062-3163
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Country | US
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Telephone | 801-889-5559
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Fax |
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Provider Business Mailing Address
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Address Line | 2435 W 450 S STE 103
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City | PLEASANT GROVE
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State | UT
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Zip | 84062-3163
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Country | US
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Telephone | 801-889-5559
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANDREW MOORE
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Credential | MD
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Telephone | 801-889-5559
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0050X
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Taxonomy Name | Non-Surgical Family Planning Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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