| |
4163 S 3200 W West Valley City UT 84119-5128 | |
(801) 964-9355 | |
(801) 967-2692 |
Full Name | |
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Speciality | Clinic/center - Multi-specialty |
Location | 4163 S 3200 W, West Valley City, Utah |
Authorized Official Name and Position | Jon Leizman (PRESIDENT) |
Authorized Official Contact | 2164799063 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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5500 Maryland Way Ste 120 Brentwood TN 37027-4993 Ph: () - | 4163 S 3200 W West Valley City UT 84119-5128 Ph: (801) 964-9355 |
NPI Number | 1063986800 |
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Provider Enumeration Date | 01/15/2019 |
Last Update Date | 08/24/2022 |
Identifier | Type | State | Issuer |
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1063986800 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
Vamos Health Ut Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3725 W 4100 S Ste 107, West Valley City, UT 84120 Phone: 502-333-2281 | |
Healing Center Of Utah Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2630 W 3500 S Ste B, West Valley City, UT 84119 Phone: 801-955-8888 Fax: 801-955-8889 |