Healthcare Provider Details

I. General information

NPI: 1720994338
Provider Name (Legal Business Name): KRIS K BARTHOLOMEW R.T.(R)(MR)(ARRT)
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2026
Last Update Date: 08/22/2026
Certification Date: 08/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1241 N LEXINGTON GREENS DR APT F103
TOOELE UT
84074-5064
US

IV. Provider business mailing address

1241 N LEXINGTON GREENS DR APT F103
TOOELE UT
84074-5064
US

V. Phone/Fax

Practice location:
  • Phone: 435-813-2434
  • Fax:
Mailing address:
  • Phone: 435-813-2434
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code247100000X
TaxonomyRadiologic Technologist
License Number6922731-5401
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code2471M1202X
TaxonomyMagnetic Resonance Imaging Radiologic Technologist
License Number6922731-5401
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: