| NPI | 1790169654 |
|---|---|
| Doing Business As | BOX ELDER CLINIC |
| Entity Type | Organization |
| Authorized Contact | LINDA C LECKMAN CEO Intermountain Medical Group 801-442-3974 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2015-07-10 |
| Last Update Date | 2015-07-10 |