| Medically Directed Care Clinic Salt Lake Llc | |
|
4465 S 900 E Ste 2754 Salt Lake City UT 84124-2469 | |
| (435) 300-0472 | |
| Not Available |
| Full Name | Medically Directed Care Clinic Salt Lake Llc |
|---|---|
| Speciality | Clinic/center |
| Location | 4465 S 900 E Ste 2754, Salt Lake City, Utah |
| Authorized Official Name and Position | Aj Yergensen (ADMIN) |
| Authorized Official Contact | 4359869369 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Medically Directed Care Clinic Salt Lake Llc 4465 S 900 E Ste 2754 Salt Lake City UT 84124-2469 Ph: () - | Medically Directed Care Clinic Salt Lake Llc 4465 S 900 E Ste 2754 Salt Lake City UT 84124-2469 Ph: (435) 300-0472 |
| NPI Number | 1548969306 |
|---|---|
| Provider Enumeration Date | 03/01/2023 |
| Last Update Date | 03/01/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548969306 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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