PREMISE HEALTH OF UTAH MEDICAL, P.C is a multi-specialty clinic center in West Valley City, UT. PREMISE HEALTH OF UTAH MEDICAL, P.C NPI is 1063986800. The provider is registered as an organization entity type.
The provider Is Doing Business As Granite Wellness Center.
The provider's business location address is:
4163 S 3200 W
WEST VALLEY CITY, UT
ZIP 84119-128
Phone: (801) 964-9355
Fax: (801) 967-2692
The provider's authorized official is Jon Leizman .
The authorized official title is President and has the following contact phone number (216) 479-9063.
The CLIA number assigned to this NPI record is 46D2117266 - physician office with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 1/15/2019 and was last updated on 8/24/2022.