NPI | 1417092883 |
---|---|
Doing Business As | INTERMOUNTAIN RIVER ROAD FAMILY MEDICINE |
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 3311) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: UT 3311) |
Enumeration Date | 2007-02-21 |
Last Update Date | 2008-07-18 |