Metamorphosis Salt Lake City, Inc.
NPI #1346495298 in Salt Lake City, Utah
Provider Information
- NPI Number
- 1346495298
- Entity Type
- Organization
- Organization Name
- Metamorphosis Salt Lake City, Inc.
- Primary Specialty
- Clinic/Center - Methadone
- Enumeration Date
- Nov 19, 2008
- Last Updated
- Nov 19, 2008
Practice Location
- Address
- 339 E 3900 S
- Address 2
- SUITE 101
- City
- Salt Lake City
- State
- Utah
- ZIP Code
- 84107-1677
- Phone
- (801) 261-5790
Authorized Official
- Name
- JERRY COSTLEY
- Title
- CHIEF OPERATING OFFICE
- Phone
- (801) 261-5790
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Methadone — Methadone |
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