| NPI | 1770941726 |
|---|---|
| Doing Business As | SOUTHRIDGE CLINIC MEDICAL SPECIALTIES |
| Entity Type | Organization |
| Authorized Contact | LINDA C LECKMAN C 801-442-3974 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Enumeration Date | 2016-02-05 |
| Last Update Date | 2016-02-05 |