Organization · Type 2 NPI
Integrated Functional Medicine
General Practice Physician · Salt Lake City, UT
NPI number
1396682258
Active
Practice location
4624 S Holladay Blvd Ste 202
Salt Lake City, UT 84117-7168
Fax (801) 277-6678
Mailing address
458 N 500 W
Bountiful, UT 84010-6948
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Vascular & Interventional Radiology Physician | 2085R0204X | None listed |
| General Practice Physician Primary | 208D00000X | None listed |
General Practice Physician: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
2 other providers at this address
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About NPI 1396682258
Integrated Functional Medicine's National Provider Identifier is 1396682258, issued on Apr 30, 2026. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in Salt Lake City, UT. The record was last updated on Apr 30, 2026.