Search › Utah › 183500000X
Mark Koelliker
NPI 1922642198 · on the registry since 2019 · sole proprietor
Practice
- Address
- 980 E Fort Union Blvd
Midvale, UT 84047 - Phone
- (801) 256-0532
- Organisation at this address
- Smiths Food & Drug Centers Inc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 6
Registry record
- Primary taxonomy
- 183500000X
183500000X
- Licence states on file
- UT
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2019-10-31
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Utah