OrganizationActive
Bridge Utah Medical Group
NPI 1104324904 · Physical Medicine & Rehabilitation Physician · Logan, UT
Provider details
- NPI number
- 1104324904
- Entity type
- Organization
- Primary specialty
- Physical Medicine & Rehabilitation PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Cameron Peterson, Chief Medical Officer, Managing Par(801) 598-8337
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Family Medicine Physician207Q00000X
Allopathic & Osteopathic Physicians
Practice location
1015 E 100 N
Logan, UT 84321-4873
Phone: (888) 221-0423
Fax: (888) 221-9816
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 1468
Bountiful, UT 84011-1468
Registry dates
- Enumerated
- 2018-01-26
- Last updated
- 2019-03-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.