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General NPI Number Information
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NPI Number | 1164504353
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Entity Type | Organization
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Legal Business Name | SYNERGIES SURGERY CENTER LP
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 348 E 4500 S SUITE 230
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City | SALT LAKE CITY
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State | UT
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Zip | 84107-3906
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Country | US
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Telephone | 801-685-6400
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Fax | 801-685-6401
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Provider Business Mailing Address
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Address Line | 348 E 4500 S SUITE 230
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City | SALT LAKE CITY
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State | UT
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Zip | 84107-3906
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Country | US
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Telephone | 801-685-6400
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Fax | 801-685-6401
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Authorized Official
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Title or Position | CFO
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Name | DON LIEDTKE
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Credential |
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Telephone | 615-344-5507
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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