Canyon Medical Group LLC

NPI #1952599409 in Logan, Utah

Provider Information

NPI Number: 1952599409
Entity Type: Organization
Organization Name: Canyon Medical Group LLC
Primary Specialty: Pediatrics
Enumeration Date: Oct 10, 2007
Last Updated: Jan 23, 2023

Practice Location

Address: 1624 N 200 E STE 160
City: Logan
State: Utah
ZIP Code: 84341-3175
Phone: (435) 750-5599

Authorized Official

Name: WENDY WIMMER
Title: MANAGER
Phone: (435) 750-5599

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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