| Rose Park Elementary Clinic | |
|
1105 W 1000 N Salt Lake City UT 84116-2135 | |
| (801) 364-2434 | |
| Not Available |
| Full Name | Rose Park Elementary Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 1105 W 1000 N, Salt Lake City, Utah |
| Authorized Official Name and Position | Linda C Leckman (CEO INTERMOUNTAIN MEDICAL GROUP) |
| Authorized Official Contact | 8013642434 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rose Park Elementary Clinic Po Box 27128 Salt Lake City UT 84127-0128 Ph: (801) 364-2434 | Rose Park Elementary Clinic 1105 W 1000 N Salt Lake City UT 84116-2135 Ph: (801) 364-2434 |
| NPI Number | 1386903185 |
|---|---|
| Provider Enumeration Date | 05/14/2012 |
| Last Update Date | 05/14/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386903185 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 4572012 (Utah) | Primary |
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