| NPI | 1356485411 |
|---|---|
| Doing Business As | INTERMOUNTAIN MANTI CLINIC |
| Entity Type | Organization |
| Authorized Contact | LINDA C LECKMAN CEO Intermountain Medical Group 801-442-3974 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 1066) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: UT 1066) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2008-07-17 |