NPI | 1710384367 |
---|---|
Doing Business As | TAYLORSVILLE SPECIALTY CLINIC |
Entity Type | Organization |
Authorized Contact | MARK BRIESACHER SVP Chief Exec Phys/Pres Im Group 801-442-3495 |
Organization Subpart ? | No |
Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: UT 742462014) |
Additional Taxonomies | 207N00000X Dermatology (Licence: UT 742462014) |
Enumeration Date | 2014-11-25 |
Last Update Date | 2018-11-29 |