Organization
IHC HEALTH SERVICES INC
Active
Other names
Avenues Urology
Organization subpart
No
Provider details
NPI number
Authorized official
MARK BRIESACHER MD (CLINICAL INTEGRATION SVP)
(801) 442-3495
Entity
Organization
Contact information
Practice address
324 E 10TH AVE STE 100, SALT LAKE CITY, UT 84103-2870
(801) 408-7500
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 408-7500
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Enumeration date
06/09/2017
Last updated
06/09/2017
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