| NPI | 1104361591 |
|---|---|
| Doing Business As | GENESIS VASCULAR OF SALT LAKE, LLC |
| Entity Type | Organization |
| Authorized Contact | DENNIS MUNFORD Manager 385-388-8003 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology |
| 2086S0129X Surgery, Vascular Surgery | |
| Enumeration Date | 2016-12-21 |
| Last Update Date | 2020-10-07 |