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50 W Broadway Ste 333 #164321 Salt Lake City UT 84101-2027 | |
| (801) 709-1470 | |
| (253) 218-6964 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 50 W Broadway Ste 333 #164321, Salt Lake City, Utah |
| Authorized Official Name and Position | Marshall Nickel (OWNER/PHYSICIAN) |
| Authorized Official Contact | 2539853501 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
50 W Broadway Ste 333 #164321 Salt Lake City UT 84101-2027 Ph: (801) 709-1470 | 50 W Broadway Ste 333 #164321 Salt Lake City UT 84101-2027 Ph: (801) 709-1470 |
| NPI Number | 1750734232 |
|---|---|
| Provider Enumeration Date | 07/19/2016 |
| Last Update Date | 01/26/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750734232 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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