| NPI | 1073808085 |
|---|---|
| Doing Business As | LIVE WELL CENTER-SALT LAKE CITY |
| Entity Type | Organization |
| Authorized Contact | LINDA C LECKMAN CEO Intermountain Medical Group 801-442-3974 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RS0010X Internal Medicine, Sports Medicine (Licence: UT 5952011) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: UT 5952011) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: UT 5952011) | |
| Enumeration Date | 2011-06-17 |
| Last Update Date | 2013-07-17 |