| Avenues Gi | |
|
324 10th Ave #249 Salt Lake City UT 84103-2853 | |
| (801) 408-5883 | |
| Not Available |
| Full Name | Avenues Gi |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 324 10th Ave, Salt Lake City, Utah |
| Authorized Official Name and Position | Linda C Leckman (CEO INTERMOUNTAIN MEDICAL GROUP) |
| Authorized Official Contact | 8014423974 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Avenues Gi Po Box 27128 Salt Lake City UT 84127-0128 Ph: (801) 408-5883 | Avenues Gi 324 10th Ave #249 Salt Lake City UT 84103-2853 Ph: (801) 408-5883 |
| NPI Number | 1174776348 |
|---|---|
| Provider Enumeration Date | 10/31/2008 |
| Last Update Date | 01/21/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174776348 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 2008IMG519 (Utah) | Primary |
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