| NPI | 1639124498 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANELL I MADONNA Director Of Contracting And Pe 801-587-6464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging |
| 2085N0700X Radiology, Neuroradiology | |
| 2085N0904X Radiology, Nuclear Radiology | |
| 2085R0203X Radiology, Therapeutic Radiology | |
| 2085R0204X Radiology, Vascular & Interventional Radiology | |
| 2085U0001X Radiology, Diagnostic Ultrasound | |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2009-04-14 |