Granger Medical Clinic

NPI #1407036619 in West Valley City, Utah

Provider Information

NPI Number: 1407036619
Entity Type: Organization
Organization Name: Granger Medical Clinic
Subpart: Yes (part of a larger organization)
Parent Organization: GRANGER MEDICAL CLINIC, INC
Primary Specialty: Otolaryngology
Enumeration Date: Nov 6, 2007
Last Updated: Nov 6, 2007

Practice Location

Address: 4052 PIONEER PKWY
Address 2: SUITE 210
City: West Valley City
State: Utah
ZIP Code: 84120-2062
Phone: (801) 966-8534

Authorized Official

Name: JON RICHARD AOKI, M.D.
Title: PHYSICIAN
Phone: (801) 965-3600

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Otolaryngology	207Y00000X	Primary

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