# UTAH BONE & JOINT CENTER LC

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

## Provider details

- **NPI number:** 1669563706
- **Authorized official:** SUSAN PETERSEN (OFFICE MANAGER)
- **Authorized official phone:** (801) 713-0606

## Contact information

- **Practice address:** 5323 S. WOODROW ST, STE 202, SALT LAKE CITY, UT 84107
- **Practice address phone:** (801) 713-0606
- **Practice address fax:** (801) 713-0609
- **Mailing address:** 5323 S. WOODROW ST, STE 202, SALT LAKE CITY, UT 84107
- **Mailing address phone:** (801) 713-0606
- **Mailing address fax:** (801) 713-0609

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/27/2006
- **Last updated:** 08/12/2008