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1124137278
FREDERIC M CIVISH
WEST VALLEY, UT
NPI
1124137278
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207Q00000X Family Medicine
(Licence: UT 184916-1205)
Enumeration Date
2006-08-30
Last Update Date
2017-01-23
Business Address
Dr. FREDERIC M CIVISH
3534 S 6000 W
WEST VALLEY, UT 84128-2610
Phone number: 801-969-6264
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Mailing Address
Dr. FREDERIC M CIVISH
3354 W 7800 S
WEST JORDAN, UT 84088-4506
Phone number: 801-282-2677
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