Bluerock Medical LLC

NPI #1629419452 in Provo, Utah

Provider Information

NPI Number: 1629419452
Entity Type: Organization
Organization Name: Bluerock Medical LLC
Primary Specialty: Specialist
Enumeration Date: Jul 9, 2013
Last Updated: Jul 9, 2013

Practice Location

Address: 3152 N UNIVERSITY AVE
Address 2: SUITE 130
City: Provo
State: Utah
ZIP Code: 84604-4745
Phone: (801) 437-4895

Authorized Official

Name: MARTHA HODGES
Title: BILLING MANAGER
Phone: (801) 437-4895

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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