Healthcare Provider Details

I. General information

NPI: 1548477607
Provider Name (Legal Business Name): UTAH VALLEY IMAGING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

458 W. 800 N.
OREM UT
84058
US

IV. Provider business mailing address

283 E 930 S
OREM UT
84058-5001
US

V. Phone/Fax

Practice location:
  • Phone: 801-802-9729
  • Fax:
Mailing address:
  • Phone: 801-225-6246
  • Fax: 801-225-1525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number State

VIII. Authorized Official

Name: LEON JAMES JENSEN JR.
Title or Position: C.O.O.
Credential:
Phone: 801-225-6246