| NPI | 1659630457 |
|---|---|
| Doing Business As | LIBERTY ELEMENTARY |
| Entity Type | Organization |
| Authorized Contact | MARK BRIESACHER Chief Phys Exec/Pres Medical Group 801-442-3495 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 4562012) |
| Enumeration Date | 2012-05-14 |
| Last Update Date | 2018-02-27 |