Organization
SALT LAKE VALLEY CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TYLER DALLAS (ADMINISTRATOR)
(801) 593-6777
Entity
Organization
Contact information
Practice address
4141 S HIGHLAND DR STE 208, HOLLADAY, UT 84124-2656
(801) 593-6777
Mailing address
PO BOX 640, KAYSVILLE, UT 84037-0640
(801) 593-6777
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
07/06/2016
Last updated
07/06/2016
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