CLANTON ENTERPRISES SERIES LLC NPI 1023490091

NPI Information

CLANTON ENTERPRISES, SERIES LLC is a medical physician assistant in Provo, UT. CLANTON ENTERPRISES, SERIES LLC NPI is 1023490091. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Precision Medical Urgent Care And Family Practice.

The provider's business location address is:

75 S 200 E
SUITE 202
PROVO, UT
ZIP 84606-146
Phone: (801) 375-2207
Fax: (801) 375-2307

The provider's authorized official is Barry A Clanton .
The authorized official title is Owner/physician and has the following contact phone number (801) 375-2207.

The CLIA number assigned to this NPI record is 46D2056854 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/25/2015 and was last updated on 6/25/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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