EVERGREEN CLINIC LLC

WEST JORDAN, UT
NPI1689210551
Entity TypeOrganization
Authorized ContactIGNACIO NICOLAS GONZALEZ
Administrator
801-850-1958
Organization Subpart ?No
Primary Taxonomy207Q00000X Family Medicine
Enumeration Date2019-11-25
Last Update Date2020-01-13
Business Address
EVERGREEN CLINIC LLC
1561 W 7000 S STE 100
WEST JORDAN, UT 84084-3556
Phone number: 801-850-1958
Mailing Address
EVERGREEN CLINIC LLC
PO BOX 9193
MIDVALE, UT 84047-9170
Phone number: 801-850-1958
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