Mobile Medical Group PC
General Practice in Salt Lake City, UT. Organization (NPI-2).
NPI number1790286367
StatusActive
Last updated in NPPESFeb 28, 2018
Details
- NPI
- 1790286367
- Entity type
- Organization (NPI-2)
- Legal business name
- Mobile Medical Group PC
- Organization subpart
- No
- Enumeration date
- Feb 28, 2018
- Last updated
- Feb 28, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208D00000X | General Practice | – | – | Yes |
Practice location
450 S 900 E Ste 150Salt Lake City, UT 84102-2959
Phone 801-835-8930 · Fax 801-981-8522
Mailing address
450 S 900 E Ste 150Salt Lake City, UT 84102-2959
Phone 801-835-8930 · Fax 801-981-8522
Authorized official
Mary M Cashma Thomas
Owner
8018358930
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