Provider Demographics
NPI:1407453160
Name:UTAH VALLEY NATURAL HEALTH CLINIC
Entity Type:Organization
Organization Name:UTAH VALLEY NATURAL HEALTH CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:WHITNEY
Authorized Official - Middle Name:JANELLE
Authorized Official - Last Name:MASSIMINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-374-5677
Mailing Address - Street 1:3311 N UNIVERSITY AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-7432
Mailing Address - Country:US
Mailing Address - Phone:801-374-5677
Mailing Address - Fax:801-374-5675
Practice Address - Street 1:3311 N UNIVERSITY AVE STE 100
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-7432
Practice Address - Country:US
Practice Address - Phone:801-374-5677
Practice Address - Fax:801-374-5675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-06
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty