Organization
INTEGRATED WELLCARE, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMISON SIVULICH (MANAGING MEMBER)
(801) 358-7567
Entity
Organization
Contact information
Practice address
5168 CRUS CORVI RD, WEST JORDAN, UT 84081-5336
(801) 358-7567
Mailing address
5168 CRUS CORVI RD, WEST JORDAN, UT 84081-5336
(801) 358-7567
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
03/25/2010
Last updated
03/25/2010
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