institution
Form Surgery Center Llc
Ambulatory Surgical Clinic/Center in Salt Lake City, Utah
NPI 1457863912

Form Surgery Center Llc is an Ambulatory Surgical Clinic/Center based in Salt Lake City, UT and is specialized in Ambulatory Surgical. Form Surgery Center Llc practices in Salt Lake City, UT. The NPI Number for Form Surgery Center Llc is 1457863912 and holds a License No. 4972C (Utah).

The current practice location address for Form Surgery Center Llc is 6322 S 3000 E Ste 170, Salt Lake City, UT and can be reached out via phone at 801-513-3223.

Location: 6322 S 3000 E Ste 170, Salt Lake City, UT, 84121-7290
institution
Provider Profile Details
NPI Number
1457863912
Provider Name
Form Surgery Center Llc
Credential
Provider Entity Type
Organization
Address
6322 S 3000 E Ste 170, Salt Lake City, UT, 84121-7290
Phone Number
801-513-3223
Fax Number
Provider Enumeration Date
10/24/2017
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
6322 S 3000 E Ste 170
City
State
Zip
84121-7290
Phone Number
801-513-3223
Fax Number
person
Provider Business Mailing Address Details
Address
6322 S 3000 E Ste 170
City
State
Zip
84121-7290
Phone Number
801-513-3223
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Ambulatory Surgical
Taxonomy
License No.
4972C (Utah)
Definition
Definition to come...
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