NPI | 1164647707 |
---|---|
Doing Business As | INTERMOUNTAIN SURGERY CENTER - AVENUES |
Entity Type | Organization |
Authorized Contact | HEATHER WALL Board Chairman 801-408-2504 |
Organization Subpart ? | No |
Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
Enumeration Date | 2007-04-17 |
Last Update Date | 2025-03-13 |