Healthcare Provider Details

I. General information

NPI: 1780330977
Provider Name (Legal Business Name): ZION MOBILE IMAGING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2022
Last Update Date: 07/19/2022
Certification Date: 07/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2008 W 1950 S
WOODS CROSS UT
84087-5034
US

IV. Provider business mailing address

2008 W 1950 S
WOODS CROSS UT
84087-5034
US

V. Phone/Fax

Practice location:
  • Phone: 801-897-5293
  • Fax: 801-992-8897
Mailing address:
  • Phone: 801-897-5293
  • Fax: 801-992-8897

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0208X
TaxonomyMobile Radiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. KATHRINA GRAN
Title or Position: OWNER
Credential:
Phone: 801-897-5293