IVY LANE PEDIATRICS, LLC

SOUTH OGDEN, UT
NPI1083635692
Entity TypeOrganization
Authorized ContactWYNDAM REEVE
Administrator
801-774-9698
Organization Subpart ?No
Primary Taxonomy251E00000X Home Health
Enumeration Date2006-07-21
Last Update Date2022-01-21
Business Address
IVY LANE PEDIATRICS, LLC
5974 FASHION POINT DR STE 230
SOUTH OGDEN, UT 84403-4805
Phone number: 801-774-9698
Mailing Address
IVY LANE PEDIATRICS, LLC
5974 FASHION POINT DR STE 230
SOUTH OGDEN, UT 84403-4805
Phone number: 801-774-9698
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