Healthcare Provider Details

I. General information

NPI: 1437255866
Provider Name (Legal Business Name): HOLLADAY FAMILY PRACTICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 08/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

999 MURRAY HOLLADAY RD SUITE 207
SALT LAKE CITY UT
84117-4901
US

IV. Provider business mailing address

999 MURRAY HOLLADAY RD SUITE 207
SALT LAKE CITY UT
84117-4901
US

V. Phone/Fax

Practice location:
  • Phone: 801-268-2584
  • Fax: 801-262-1168
Mailing address:
  • Phone: 801-268-2584
  • Fax: 801-262-1168

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. BRIAN C RASMUSSEN
Title or Position: SENIOR PARTNER
Credential: M.D.
Phone: 801-268-2584