Provider Demographics
NPI:1376645671
Name:UNIVERSITY HEALTH CARE QUICK CLINIC
Entity Type:Organization
Organization Name:UNIVERSITY HEALTH CARE QUICK CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:TERRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-587-6833
Mailing Address - Street 1:PO BOX 510721
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84151-0721
Mailing Address - Country:US
Mailing Address - Phone:801-581-6600
Mailing Address - Fax:
Practice Address - Street 1:3981 SOUTH WASATCH BLVD
Practice Address - Street 2:
Practice Address - City:HOLLADAY
Practice Address - State:UT
Practice Address - Zip Code:84124-2247
Practice Address - Country:US
Practice Address - Phone:801-213-9500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Not Answered363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty