Organization
KETAMINE FOR DEPRESSION SALT LAKE CITY LLC
Active
Other names
KetamineSLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NICOLAS SALOMON JR. (DIRECTOR)
(385) 474-6946
Entity
Organization
Contact information
Practice address
201 E 5900 S STE 200, MURRAY, UT 84107-5432
(385) 474-6946
(385) 355-2782
Mailing address
201 E 5900 S STE 200, MURRAY, UT 84107-5432
(385) 474-6946
(385) 355-2782
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
01/03/2025
Last updated
01/03/2025
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