Centennial Medical Practice PC

NPI #1174333975 in Park City, Utah

Provider Information

NPI Number
1174333975
Entity Type
Organization
Organization Name
Centennial Medical Practice PC
Primary Specialty
Specialist
Enumeration Date
Jan 13, 2025
Last Updated
Jan 13, 2025

Practice Location

Address
1743 SIDEWINDER DRIVE
Address 2
#114
State
Utah
ZIP Code
84060-7322
Phone
(307) 840-9834

Authorized Official

Name
ASHWIN MURALIDHARAN
Title
PRESIDENT
Phone
(307) 840-9834

Specialties & Taxonomy Codes

Specialty
Specialist

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