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General NPI Number Information
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NPI Number | 1437209186
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Entity Type | Organization
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Legal Business Name | LAKEVIEW PROFESSIONAL BILLING
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 630 MEDICAL DR
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City | BOUNTIFUL
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State | UT
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Zip | 84010-4908
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Country | US
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Telephone | 801-299-7802
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Fax | 801-299-7803
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Provider Business Mailing Address
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Address Line | PO BOX 639
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City | BOUNTIFUL
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State | UT
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Zip | 84011-0639
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Country | US
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Telephone | 801-299-7802
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Fax | 801-299-7803
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Authorized Official
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Title or Position | BILLER
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Name | TENNILEL MICHAELIS
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Credential |
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Telephone | 801-299-7802
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225B00000X
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Taxonomy Name | Pulmonary Function Technologist
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License Number | 167432-1205
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License Number State | UT
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