Organization
CENTRIC PHYSICIANS INTERMOUNTAIN REGION, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA E. GIVENS MD (CEO)
(830) 267-4575
Entity
Organization
Contact information
Practice address
7101 N MESA STREET #365, SALT LAKE CITY, UT 84101-1603
(830) 267-4575
(830) 267-4575
Mailing address
113 PLEASANT VALLEY DR STE 210, BOERNE, TX 78006-5683
(830) 267-4575
(830) 267-4575
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
11/07/2019
Last updated
04/03/2020
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