| NPI | 1699172122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA LECKMAN CEO Intermountain Medical Group 801-442-3974 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: UT 742442014) |
| Enumeration Date | 2014-11-26 |
| Last Update Date | 2017-01-27 |