MEDICARE: ROXBURY INSTITUTE SALT LAKE CITY PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM2500X	Medical Specialty Clinic/Center

General Provider Information

NPI Number	:	1629855937
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROXBURY INSTITUTE SALT LAKE CITY PLLC

Provider Business Mailing Address
First Line	:	6344 S 900 E
Second Line	:
City	:	MURRAY
State	:	UT
Zip	:	84121-2439
Country	:	US
Telephone Number	:	918-851-3715
Fax Number	:

Provider Business Practice Location Address
First Line	:	6344 S 900 E
Second Line	:
City	:	MURRAY
State	:	UT
Zip	:	84121-2439
Country	:	US
Telephone Number	:	918-851-3715
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MRS. KASSIE L AVILA
Credential	:
Telephone Number	:	918-851-3715

Provider Enumeration Date	:	09/11/2023
Last Update Date	:	09/11/2023

Similar Medicare Providers

1770866840 — MICHAEL T CHISM OPTOMETRY STUDENT
Practice Location Address:

6344 S 900 E
MURRAY, UT
84121-2439

Practice Phone: 801-892-8222
Practice Fax:

1770360091 — ROXBURY INSTITUTE SLC SURGICAL CENTER LLC
Practice Location Address:

6344 S 900 E
MURRAY, UT
84121-2439

Practice Phone: 918-851-3715
Practice Fax:

1831175629 — GREGORY ALAN CHRISTIANSEN M.D.
Practice Location Address:

6344 S 900 E
SALT LAKE CITY, UT
84121-2439

Practice Phone: 801-892-8222
Practice Fax: 801-904-3436

1518307909 — GLAUKOM LLC
Practice Location Address:

6344 S 900 E
SALT LAKE CITY, UT
84121-2439

Practice Phone: 801-892-8222
Practice Fax: 801-904-3436

1255721767 — PAMELA ALANIS
Practice Location Address:

5965 S 900 E
MURRAY, UT
84121-1720

Practice Phone: 801-263-7138
Practice Fax:

1538131461 — MS. MARIAN KAYE KNUDSON LCSW
Practice Location Address:

5802 S 900 E # 5
MURRAY, UT
84121-1644

Practice Phone: 801-671-3894
Practice Fax:

Directions to “ROXBURY INSTITUTE SALT LAKE CITY PLLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.