Main Street Clinic LLC

NPI #1750728176 in Manti, Utah

Provider Information

NPI Number: 1750728176
Entity Type: Organization
Organization Name: Main Street Clinic LLC
Primary Specialty: Clinic/Center
Enumeration Date: May 24, 2013
Last Updated: May 24, 2013

Practice Location

Address: 46 N MAIN ST
City: Manti
State: Utah
ZIP Code: 84642-1254
Phone: (435) 835-6000

Authorized Official

Name: MRS. LAUREN LINN MILLER, FNP-BC
Title: OWNER
Phone: (435) 835-6000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X	Primary

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