# FJM BASECAMP

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** FUTURA MEDICAL CLINIC
- **Other names:** FJM Medical Clinic-BaseCamp
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1255858734
- **Legal business name:** FUTURA MEDICAL CLINIC
- **Authorized official:** DARCE A LATSIS (OPERATIONS MANAGER)
- **Authorized official phone:** (801) 441-1002

## Contact information

- **Practice address:** 185 S STATE ST STE 208, SALT LAKE CITY, UT 84111-1558
- **Practice address phone:** (801) 821-5454
- **Practice address fax:** (801) 821-5455
- **Mailing address:** 560 S 300 E STE 275, SALT LAKE CITY, UT 84111-3586
- **Mailing address phone:** (801) 441-1002

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 70786441205 | UT | Yes |

## Other

- **Enumeration date:** 08/25/2017
- **Last updated:** 07/21/2022