Form Surgery Center LLC
Form Surgery Center LLC is an Ambulatory Surgical Clinic/Center in Salt Lake City, Utah. Licensed in Utah. Registered with an NPI since 2017.
- Licensed in
- UT
- In the registry since
- 2017
What do these letters mean?
- LLC — Limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
6322 S 3000 E Ste 170Salt Lake City, UT 84121-7290
Phone: (801) 513-3223
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Ambulatory Surgical Clinic/Center (primary) | Taxonomy 261QA1903X · Licence 4972C (UT) |
|---|
Record details
| NPI number | 1457863912 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Janie Ward — Owner · (801) 513-3223 |
| NPI enumerated | October 24, 2017 |
| Last updated in NPPES | April 5, 2021 |
| Certification date | April 5, 2021 |
| Mailing address | 6322 S 3000 E Ste 170, Salt Lake City, UT 84121-7290 |
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