| NPI | 1629771589 |
|---|---|
| Doing Business As | SSSL SPEC SURG SLC |
| Other Name | GENERAL & BREAST SURGERY SALT LAKE |
| Other Name | SPECIALTY SURGERY SALT LAKE CITY |
| Entity Type | Organization |
| Authorized Contact | ANGELA J SKINNER Administrator, Oma 303-673-7175 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Enumeration Date | 2023-03-22 |
| Last Update Date | 2025-11-10 |