Salt Lake City Vamc

NPI #1124062898 in Roosevelt, Utah

Provider Information

NPI Number: 1124062898
Entity Type: Organization
Organization Name: Salt Lake City Vamc
Primary Specialty: Clinic/Center - VA
Enumeration Date: Jun 15, 2006
Last Updated: Jan 17, 2018

Practice Location

Address: 245 W 200 N
City: Roosevelt
State: Utah
ZIP Code: 84066-2740
Phone: (913) 578-4409

Authorized Official

Name: ERIN POTTER
Title: NPI TEAM MEMBER
Phone: (202) 382-2579

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - VA — VA	261QV0200X	Primary

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