Organization
SLEEP DISORDERS CLINIC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY JEAN WALKER (APRN)
(801) 938-5362
Entity
Organization
Contact information
Practice address
688 E UNION SQ # 101, SANDY, UT 84070-3403
(801) 631-5979
Mailing address
688 E UNION SQ # 101, SANDY, UT 84070-3403
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1888684405
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508851890
—
UT
Enumeration date
07/06/2017
Last updated
06/16/2018
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