NPI | 1922143643 |
---|---|
Doing Business As | SOUTH OGDEN CLINIC |
Entity Type | Organization |
Authorized Contact | LINDA C LECKMAN CEO Intermountain Medical Group 801-442-3974 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 204) |
Enumeration Date | 2007-02-20 |
Last Update Date | 2008-07-30 |