HEALTH DIVERSIFIED - MEDICAL GROUP OF UTAH LLC

HOLLADAY, UT
NPI1508518085
Entity TypeOrganization
Authorized ContactANN SMITH
Authorized Official
801-682-6817
Organization Subpart ?No
Primary Taxonomy261QM1300X Clinic/Center, Multi-Specialty
Additional Taxonomies103TC1900X Psychologist, Counseling
1041C0700X Social Worker, Clinical
133V00000X Dietitian, Registered
207P00000X Emergency Medicine
207Q00000X Family Medicine
207R00000X Internal Medicine
207SG0201X Medical Genetics, Clinical Genetics (M.D.)
207V00000X Obstetrics & Gynecology
208000000X Pediatrics
225100000X Physical Therapist
251B00000X Case Management
261QC1800X Clinic/Center, Corporate Health
363A00000X Physician Assistant
363L00000X Nurse Practitioner
Enumeration Date2022-01-25
Last Update Date2023-09-15
Business Address
HEALTH DIVERSIFIED - MEDICAL GROUP OF UTAH LLC
4544 S HOLLADAY BLVD
HOLLADAY, UT 84117-4404
Phone number: 801-682-6817
Mailing Address
HEALTH DIVERSIFIED - MEDICAL GROUP OF UTAH LLC
5986 S TOLCATE WOODS LN
HOLLADAY, UT 84121-1536
Phone number: 801-682-6817