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General NPI Number Information
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NPI Number | 1487469201
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Entity Type | Organization
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Legal Business Name | NEUROGUARD MONITORING PLLC
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Dates
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Enumeration Date | 02/10/2025
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 1200 E 3900 S STE 3G
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City | SALT LAKE CITY
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State | UT
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Zip | 84124-1300
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Country | US
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Telephone | 801-346-7788
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Fax | 801-650-7788
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Provider Business Mailing Address
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Address Line | 1200 E 3900 S STE 3G
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City | SALT LAKE CITY
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State | UT
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Zip | 84124-1300
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Country | US
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Telephone | 801-346-7788
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Fax | 801-650-7788
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Authorized Official
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Title or Position | OWNER
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Name | KADE HUNTSMAN
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Credential | MD
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Telephone | 801-346-7788
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number |
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License Number State |
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