Main Street Family Medicine Pllc
NPI #1518636844 in Enterprise, Utah
Provider Information
- NPI Number
- 1518636844
- Entity Type
- Organization
- Organization Name
- Main Street Family Medicine Pllc
- Primary Specialty
- Family Medicine
- Enumeration Date
- Sep 9, 2021
- Last Updated
- Oct 29, 2021
Practice Location
- Address
- 571 EAST MAIN STREET
- City
- Enterprise
- State
- Utah
- ZIP Code
- 84725
- Phone
- (435) 878-5711
Authorized Official
- Name
- COLTEN DIRK BRACKEN, MD
- Title
- MD/OWNER
- Phone
- (435) 878-5711
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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