State of Utah

NPI #1982429528 in Slc, Utah

Provider Information

NPI Number
1982429528
Entity Type
Organization
Organization Name
State of Utah
Subpart
Yes (part of a larger organization)
Parent Organization
STATE OF UTAH
Primary Specialty
Clinic/Center - Prison Health
Enumeration Date
Nov 19, 2024
Last Updated
Nov 19, 2024

Practice Location

Address
195 N 1950 W
City
Slc
State
Utah
ZIP Code
84116-3100
Phone
(801) 538-4330

Authorized Official

Name
BRETT PETERSEN
Title
DIVISION DIRECTOR
Phone
(801) 538-4330

Specialties & Taxonomy Codes

Specialty
Clinic/Center - Prison HealthPrison Health

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