NPI 1184657041 · live from the CMS NPI Registry
Granger Medical Clinic PC
Clinic/Center, Multi-Specialty in West Valley City, UT. National Provider Identifier 1184657041, active.
NPI record
| NPI | 1184657041 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Clinic/Center, Multi-Specialty 261QM1300X |
| Practice location | 2965 W. 3500 S., West Valley City, UT 84119 |
| Practice phone | 801-965-3600 |
| Mailing address | 2965 W 3500 S, West Valley City, UT 84119 |
| Enumerated | July 7, 2006 |
| Last updated | December 13, 2023 |
| Authorized official | Mary Jane Pennington, President |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Orthopaedic Surgery | 207X00000X | — |
| Otolaryngology | 207Y00000X | — |
| Physical Medicine & Rehabilitation | 208100000X | — |
| Plastic Surgery, Surgery of the Hand | 2082S0105X | — |
| Psychiatry & Neurology, Neurology | 2084N0400X | — |
| Pediatrics | 208000000X | — |
| Internal Medicine | 207R00000X | — |
| Internal Medicine, Gastroenterology | 207RG0100X | — |
| Obstetrics & Gynecology | 207V00000X | — |
| Family Medicine | 207Q00000X | — |
| Surgery | 208600000X | — |
| Clinic/Center, Multi-Specialty primary | 261QM1300X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.