# ROXBURY INSTITUTE SALT LAKE CITY PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629855937
- **Authorized official:** MRS. KASSIE L AVILA (MANAGER)
- **Authorized official phone:** (918) 851-3715

## Contact information

- **Practice address:** 6344 S 900 E, MURRAY, UT 84121-2439
- **Practice address phone:** (918) 851-3715
- **Mailing address:** 6344 S 900 E, MURRAY, UT 84121-2439
- **Mailing address phone:** (918) 851-3715

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/11/2023
- **Last updated:** 09/11/2023