| NPI | 1144475674 |
|---|---|
| Doing Business As | MOUNTAINSTAR CACHE VALLEY MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | LOUIS JOSEPH VP 615-373-7630 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2008-11-25 |
| Last Update Date | 2023-01-02 |