Provider Demographics
NPI:1528055431
Name:RIVERTON FAMILY HEALTH CENTER LLC
Entity type:Organization
Organization Name:RIVERTON FAMILY HEALTH CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:C
Authorized Official - Last Name:MONSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-254-0309
Mailing Address - Street 1:1756 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERTON
Mailing Address - State:UT
Mailing Address - Zip Code:84065-4701
Mailing Address - Country:US
Mailing Address - Phone:801-254-0309
Mailing Address - Fax:801-254-1012
Practice Address - Street 1:1756 PARK AVE
Practice Address - Street 2:
Practice Address - City:RIVERTON
Practice Address - State:UT
Practice Address - Zip Code:84065-4701
Practice Address - Country:US
Practice Address - Phone:801-254-0309
Practice Address - Fax:801-254-1012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-05
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207Q00000X
UT23511207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty