| NPI | 1164558847 |
|---|---|
| Doing Business As | SANDY CLINIC |
| Entity Type | Organization |
| Authorized Contact | LINDA C LECKMAN CEO Intermountain Medical Group 801-442-3974 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: UT 55767) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: UT 55767) |
| 207K00000X Allergy & Immunology (Licence: UT 55767) | |
| 207N00000X Dermatology (Licence: UT 55767) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: 55767) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: UT 55767) | |
| 207W00000X Ophthalmology (Licence: 55767) | |
| 208000000X Pediatrics (Licence: UT 55767) | |
| 208200000X Plastic Surgery (Licence: UT 55767) | |
| 208600000X Surgery (Licence: UT 55767) | |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2008-07-31 |