Passport Health Holdings, LLC

NPI #1205377736 in Provo, Utah

Provider Information

NPI Number: 1205377736
Entity Type: Organization
Organization Name: Passport Health Holdings, LLC
Primary Specialty: Preventive Medicine - Public Health & General Preventive Medicine
Enumeration Date: Mar 16, 2017
Last Updated: Mar 16, 2017

Practice Location

Address: 1055 NORTH 300 WEST
Address 2: STE 416
City: Provo
State: Utah
ZIP Code: 84604-3354
Phone: (877) 358-8648

Authorized Official

Name: MR. DOUG SHACKELL
Title: DIRECTOR OF FINANCE
Phone: (480) 646-9024

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Preventive Medicine - Public Health & General Preventive Medicine — Public Health & General Preventive Medicine	2083P0901X	Primary

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