| NPI | 1659701670 |
|---|---|
| Doing Business As | INTERMOUNTAIN AVENUES WOMEN'S CENTER |
| Entity Type | Organization |
| Authorized Contact | LINDA C LECKMAN CEO Intermountain Medical Group 801-442-3974 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: UT 6342014) |
| Additional Taxonomies | 176B00000X Midwife (Licence: UT 6342014) |
| Enumeration Date | 2013-11-13 |
| Last Update Date | 2013-11-13 |