| NPI | 1689709859 |
|---|---|
| Doing Business As | AVENUES SPECIALTY CLINIC |
| Entity Type | Organization |
| Authorized Contact | LINDA C LECKMAN CEO Intermountain Medical Group 801-442-3974 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: UT 20040897) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: UT 20040897) |
| 208800000X Urology (Licence: UT 6312010) | |
| 207V00000X Obstetrics & Gynecology (Licence: UT 6312010) | |
| 163WW0101X Registered Nurse, Women's Health Care, Ambulatory (Licence: UT 6312010) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: UT 6312010) | |
| 208600000X Surgery (Licence: UT 6312010) | |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2010-09-03 |