Intermountain Spine And Pain Center

NPI 1215057955 - Clinic/Center - 261QA1903X

NPI Details
NPI 1215057955
Enumeration Date 03/29/2007
Last Updated 04/20/2008
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name TRACEY H TRACEY
Position ACCOUNTS MANAGER
Phone (435) 753-1600
Fax (435) 753-9521
Practice Location
286 N GATEWAY DR
PROVIDENCE UT, 84332-9733, US
Phone (435) 753-1600
Fax (435) 753-9521
Business Location
274 N MAIN ST
LOGAN UT, 84321-3915, US
Phone (435) 753-1600
Fax (435) 753-9521
Toxanomy
Taxonomy Code 261QA1903X
License State Utah
License Number 0329116-1204
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According to our database, Intermountain Spine And Pain Center NPI is 1215057955, taxonomy code is 261QA1903X and license number is 0329116-1204, license state is located at Utah. Intermountain Spine And Pain Center physically located at 286 N Gateway Dr, Providence UT, 84332-9733. NPI Number 1033115704 has the healthcare provider type.

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1215057955 NPI number is provided on an as is basis without warranty of any kind. 1215057955 is maintained by the National Plan & Provider Enumeration System. The contents of Intermountain Spine And Pain Center are for informational purposes only.