| Premise Health Of Utah Medical, P.c | |
|
4163 S 3200 W West Valley City UT 84119-5128 | |
| (801) 964-9355 | |
| (801) 967-2692 |
| Full Name | Premise Health Of Utah Medical, P.c |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 4163 S 3200 W, West Valley City, Utah |
| Authorized Official Name and Position | Jon Leizman (PRESIDENT) |
| Authorized Official Contact | 2164799063 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Premise Health Of Utah Medical, P.c 5500 Maryland Way Ste 120 Brentwood TN 37027-4993 Ph: () - | Premise Health Of Utah Medical, P.c 4163 S 3200 W West Valley City UT 84119-5128 Ph: (801) 964-9355 |
| NPI Number | 1063986800 |
|---|---|
| Provider Enumeration Date | 01/15/2019 |
| Last Update Date | 08/24/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063986800 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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