Organization
SMP FAMILY MEDICINE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLA IRENE RILEY M.D. (OWNER)
(801) 747-0922
Entity
Organization
Contact information
Practice address
1220 E 3900 S, SUITE 4A, SALT LAKE CITY, UT 84124-1377
(801) 747-0922
(801) 747-0924
Mailing address
PO BOX 932, SANDY, UT 84091-0932
(801) 553-9568
(801) 553-9562
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
56658201205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
099643665001
—
UT
Enumeration date
06/29/2006
Last updated
11/03/2008
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