Vivint Medical Clinic

NPI #1265942163 in Provo, Utah

Provider Information

NPI Number: 1265942163
Entity Type: Organization
Organization Name: Vivint Medical Clinic
Subpart: Yes (part of a larger organization)
Parent Organization: FUTURA MEDICAL CLINIC
Primary Specialty: Family Medicine
Enumeration Date: Oct 5, 2017
Last Updated: Jan 30, 2020

Practice Location

Address: 4907 NORTH 300 WEST
City: Provo
State: Utah
ZIP Code: 84604-8460
Phone: (801) 705-8040

Authorized Official

Name: DARCE LATSIS
Title: OPERATIONS MANAGER
Phone: (801) 705-8040

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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