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Organization
SKYLINE PAIN CLINIC
Active
Organization
SKYLINE PAIN CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAHAN IMANI MD (OWNER)
(801) 476-4448
Entity
Organization
Contact information
Practice address
5315 ADAMS AVE PKWY, SUITE A, OGDEN, UT 84405-4766
(801) 476-4448
(801) 476-4449
Mailing address
PO BOX 9519, OGDEN, UT 84409-0519
(801) 476-4448
(801) 476-4449
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
260615
UT
Other
Enumeration date
09/30/2005
Last updated
12/23/2009
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