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General NPI Number Information
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NPI Number | 1841016672
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Entity Type | Organization
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Legal Business Name | WASATCH MEDICAL IMAGING LLC
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Dates
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Enumeration Date | 11/26/2024
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Last Update Date | 11/26/2024
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Provider Practice Location Address
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Address Line | 1776 NORTH HIGHWAY 40 SUITE 103
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City | HEBER
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State | UT
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Zip | 84032-4148
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Country | US
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Telephone | 719-650-4347
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Fax | 801-692-1873
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Provider Business Mailing Address
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Address Line | 1776 NORTH HIGHWAY 40 SUITE 103
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City | HEBER
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State | UT
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Zip | 84032-4148
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Country | US
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Telephone | 719-650-4347
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Fax | 801-692-1873
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Authorized Official
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Title or Position | MANAGER/OWNER
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Name | MR. BRENT K ASHBY
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Credential |
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Telephone | 719-964-7813
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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