| Organization Name: | CHOICE CARE CLINIC OF UTAH, INC. |
| NPI Number: | 1619248754 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RICHARD A CARTER (OFFICER) |
| Mailing Address: | 406 W South Jordan Pkwy Suite 450 South Jordan |
| State: | UT US |
| Postal Code: | 840953965 |
| Phone Number: | 8019843418 |
| Fax Number: | 8019843479 |
| NPI Enumeration Date: | 01/20/2012 |
| NPI Last Update Date: | 01/20/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |