Organization
FJM BASECAMP
Active
Parent organization
FUTURA MEDICAL CLINIC
Other names
FJM Medical Clinic-BaseCamp
Organization subpart
Yes
Provider details
NPI number
Legal business name
FUTURA MEDICAL CLINIC
Authorized official
DARCE A LATSIS (OPERATIONS MANAGER)
(801) 441-1002
Entity
Organization
Contact information
Practice address
185 S STATE ST STE 208, SALT LAKE CITY, UT 84111-1558
(801) 821-5454
(801) 821-5455
Mailing address
560 S 300 E STE 275, SALT LAKE CITY, UT 84111-3586
(801) 441-1002
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
70786441205
UT
Other
Enumeration date
08/25/2017
Last updated
07/21/2022
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