FORM SURGERY CENTER LLC

Clinic/Center - Ambulatory Surgical

Active Organization
NPI: 1457863912

Practice Address

6322 S 3000 E STE 170
Salt Lake City, UT 84121

Phone: (801) 513-3223

Specialties

Specialty Code Primary License
Clinic/Center - Ambulatory Surgical 261QA1903X Yes 4972C (UT)

Frequently Asked Questions

NPI 1457863912 is the National Provider Identifier for FORM SURGERY CENTER LLC, a Clinic/Center - Ambulatory Surgical provider located in Salt Lake City, UT. This NPI was enumerated on October 24, 2017.

Quick Facts

NPI
1457863912
Type
Organization
Enumerated
Oct 24, 2017
Last Updated
Apr 5, 2021

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