Organization
UNIVERSITY OF UTAH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EVELYN CHARLOTTE LOOSE M.D. (ASSISTANT PROFESSOR)
(801) 205-1003
Entity
Organization
Contact information
Practice address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0001
(801) 581-6393
Mailing address
1952 MAPLE HOLLOW WAY, BOUNTIFUL, UT 84010-1041
(801) 205-1003
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
3764091205
UT
282NC0060X
Critical Access Hospital
3674091205
UT
Other
Enumeration date
01/08/2010
Last updated
01/08/2010
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