| Full Name | |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 5770 S 250 E, Murray, Utah |
| Authorized Official Name and Position | Kelly J Howard (DIRECTOR) |
| Authorized Official Contact | 8014421425 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 27128 Salt Lake City UT 84127-0128 Ph: (801) 442-1400 | 5770 S 250 E Murray UT 84107-8100 Ph: (801) 314-2210 |
| NPI Number | 1689976532 |
|---|---|
| Provider Enumeration Date | 11/29/2010 |
| Last Update Date | 11/29/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689976532 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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