| Granger Medical Clinic - Wasatch | |
|
1160 E 3900 S Suite 1000 Salt Lake City UT 84124-1202 | |
| (801) 262-1771 | |
| (801) 288-9101 |
| Full Name | Granger Medical Clinic - Wasatch |
|---|---|
| Speciality | Internal Medicine |
| Location | 1160 E 3900 S, Salt Lake City, Utah |
| Authorized Official Name and Position | Anne M Whitaker (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 8019653505 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Granger Medical Clinic - Wasatch 1160 E 3900 S Suite 1000 Salt Lake City UT 84124-1202 Ph: (801) 262-1771 | Granger Medical Clinic - Wasatch 1160 E 3900 S Suite 1000 Salt Lake City UT 84124-1202 Ph: (801) 262-1771 |
| NPI Number | 1629163746 |
|---|---|
| Provider Enumeration Date | 10/04/2006 |
| Last Update Date | 08/16/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629163746 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 870526286 (Utah) | Primary |
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