| NPI | 1588799654 |
|---|---|
| Doing Business As | BOUNTIFUL 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 2006-31121) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: UT 2006-31121) |
| 207K00000X Allergy & Immunology (Licence: UT 2006-31121) | |
| 207R00000X Internal Medicine (Licence: UT 2006-31121) | |
| 207V00000X Obstetrics & Gynecology (Licence: UT 2006-31121) | |
| 208000000X Pediatrics (Licence: UT 2006-31121) | |
| 2085B0100X Radiology Body Imaging (Licence: UT 2006-31121) | |
| 2085U0001X Radiology Diagnostic Ultrasound (Licence: UT 2006-31121) | |
| 208600000X Surgery (Licence: UT 2006-31121) | |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2008-07-30 |