Organization
CENTER FOR COLON AND RECTAL DISEASES LLC
Active
Other names
CCRD
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA M LEVER (PRACTICE ADMINISTRATOR)
(801) 265-3978
Entity
Organization
Contact information
Practice address
348 E 4500 S, SUITE 200, SALT LAKE CITY, UT 84107-3906
(801) 265-3978
(801) 265-3988
Mailing address
348 E 4500 S, SUITE 200, SALT LAKE CITY, UT 84107-3906
(801) 265-3978
(801) 265-3988
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
10/24/2006
Last updated
08/22/2020
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