CARESOURCE
Organization (NPI-2)
Active
Family Medicine, Hospice and Palliative Medicine
Provider Information
- NPI Number
1124242128- Provider Type
- Organization / Facility (NPI-2)
- Status
- Active
Contact & Location
- Address
- 1624 E 4500 S, SALT LAKE CITY, UT, 841174212
- Phone
- (801) 266-7200
- Fax
- (801) 266-7004
Specialties & Taxonomies
Family Medicine
License: UT #5221090-1205
Family Medicine, Hospice and Palliative Medicine
Primary License: UT #5221090-1205