NPI | 1255858734 |
---|---|
Doing Business As | FJM MEDICAL CLINIC-BASECAMP |
Entity Type | Organization |
Authorized Contact | DARCE A LATSIS Operations Manager 801-441-1002 |
Organization Subpart ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 70786441205) |
Enumeration Date | 2017-08-25 |
Last Update Date | 2022-07-21 |