Organization
MA BO INC
Active
Other names
House Call Doctors
Organization subpart
No
Provider details
NPI number
Authorized official
MISS CAITLIN CACCIATORE (PRACTICE MANAGER)
(801) 485-5055
Entity
Organization
Contact information
Practice address
466 E 500 S STE 200, SALT LAKE CITY, UT 84111-3350
(801) 485-5055
(801) 467-3296
Mailing address
466 E 500 S STE 200, SALT LAKE CITY, UT 84111-3350
(801) 485-5055
(801) 467-3296
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000057838
PTAN
UT
Enumeration date
11/26/2007
Last updated
07/19/2024
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