Organization
MEDICALLY DIRECTED CARE CLINIC SALT LAKE LLC
Active
Other names
MDC CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
AJ YERGENSEN (ADMIN)
(435) 986-9369
Entity
Organization
Contact information
Practice address
4465 S 900 E STE 2754, SALT LAKE CITY, UT 84124-2469
(435) 300-0472
Mailing address
4465 S 900 E STE 2754, SALT LAKE CITY, UT 84124-2469
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
03/01/2023
Last updated
03/01/2023
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