Organization
GARFIELD COUNTY
Active
Other names
Kazan Ivan W. Memorial Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALBERTO VASQUEZ (ADMINISTRATOR)
(435) 676-8811
Entity
Organization
Contact information
Practice address
65 N CENTER, ESCALANTE, UT 84726-0276
(435) 826-4374
Mailing address
4646 LAKE PARK BLVD, SALT LAKE CITY, UT 84120-8212
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
06/01/2007
Last updated
02/25/2016
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