Avicenna Pc is a Specialist based in Sandy, UT. Avicenna Pc practices in Sandy, UT. The NPI Number for Avicenna Pc is 1952475410 and holds a License No. 2764211205 (Utah).
The current practice location address for Avicenna Pc is 8706 S 700 E, Sandy, UT and can be reached out via phone at 801-942-6000 and via fax at 801-748-4069.
Location: 8706 S 700 E, Sandy, UT, 84070-1807
Provider Profile Details
NPI Number
1952475410
Provider Name
Avicenna Pc
Credential
Provider Entity Type
Organization
Address
8706 S 700 E, Sandy, UT, 84070-1807
Phone Number
801-942-6000
Fax Number
801-748-4069
Provider Enumeration Date
11/17/2006
Last Update Date
03/08/2024
Provider's Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000059664 | 01 | UT | MEDICARE ID-PIN |
Provider Business Practice Location Address Details
Address
8706 S 700 E
City
State
Zip
84070-1807
Phone Number
801-942-6000
Fax Number
801-748-4069
Provider Business Mailing Address Details
Address
8706 S 700 E
City
State
Zip
84070-1807
Phone Number
801-942-6000
Fax Number
801-748-4069
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
License No.
2764211205 (Utah)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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