Organization
DR. BRIAN LILJENQUIST PLLC
Active
Other names
Surgical Wound Care Associates, Elite Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN LILJENQUIST DPM (MANAGING PARTNER)
(801) 869-4100
Entity
Organization
Contact information
Practice address
1250 E 3900 S STE 440, SALT LAKE CITY, UT 84124
(801) 869-4100
(801) 869-4119
Mailing address
1250 E 3900 S STE 440, SALT LAKE CITY, UT 84124-1349
(801) 869-4100
(801) 869-4119
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
9140789-1205
UT
208600000X
Surgery Physician
8763069-1204
UT
2086S0127X
Trauma Surgery Physician
8763069-1204
UT
213ES0103X
Foot & Ankle Surgery Podiatrist
83699990501
UT
2251G0304X
Geriatric Physical Therapist
292357-2401
UT
261QM1300X
Multi-Specialty Clinic/Center
Primary
8763069-1204
UT
Other
Enumeration date
02/21/2017
Last updated
06/16/2018
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