Organization
AUSTIN MED GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADAM BOLAFT (CEO)
(385) 414-4720
Entity
Organization
Contact information
Practice address
515 S 700 E, SALT LAKE CITY, UT 84102-2801
(801) 343-1220
Mailing address
515 S 700 E, SALT LAKE CITY, UT 84102-2801
(801) 343-1220
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4859745-1265
UT
Other
Enumeration date
08/13/2012
Last updated
09/18/2012
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