Healthcare Provider Details

I. General information

NPI: 1376645671
Provider Name (Legal Business Name): UNIVERSITY HEALTH CARE QUICK CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3981 SOUTH WASATCH BLVD
HOLLADAY UT
84124-2247
US

IV. Provider business mailing address

PO BOX 510721
SALT LAKE CITY UT
84151-0721
US

V. Phone/Fax

Practice location:
  • Phone: 801-213-9500
  • Fax:
Mailing address:
  • Phone: 801-581-6600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. SUSAN A TERRY
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 801-587-6833