PROVAS OF SALT LAKE, LLC

SANDY, UT
NPI1407410244
Entity TypeOrganization
Authorized ContactJOHN HEWETT
Medical Director
801-386-4240
Organization Subpart ?No
Primary Taxonomy2085R0204X Radiology, Vascular & Interventional Radiology
Enumeration Date2019-04-26
Last Update Date2019-04-26
Business Address
PROVAS OF SALT LAKE, LLC
909 E 9400 S
SANDY, UT 84094-5514
Phone number: 801-386-4240
Mailing Address
PROVAS OF SALT LAKE, LLC
909 E 9400 S
SANDY, UT 84094-5514
Phone number: 801-386-4240