Organization
INTERMOUNTAIN HEALTH CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL MINER M.D. (MEDICAL DIRECTOR)
(801) 314-4500
Entity
Organization
Contact information
Practice address
5770 S 250 E STE 310, MURRAY, UT 84107-8110
(801) 314-4500
(801) 314-2909
Mailing address
5770 S 250 E STE 310, MURRAY, UT 84107-8110
(801) 314-4500
(801) 314-2909
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
195697-3102
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000055456
INTERMOUNTAIN MEDICAL GROUP
UT
Enumeration date
06/28/2013
Last updated
06/28/2013
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