| NPI | 1467705087 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SETH GLICKMAN Intmn Medical Group Pres/Cmo Cbc 801-442-2905 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: UT 2742012) |
| Enumeration Date | 2012-10-19 |
| Last Update Date | 2019-11-05 |