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Organization
MMPS OGDEN
Active
Organization
MMPS OGDEN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JULIE PENROD CEO (CEO)
(801) 284-1705
Entity
Organization
Contact information
Practice address
1485 E SKYLINE DR, OGDEN, UT 84405-4837
(801) 475-4552
(801) 475-4578
Mailing address
1485 E SKYLINE DR, OGDEN, UT 84405-4837
(801) 475-4552
(801) 475-4578
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
5032435-0160
UT
261QR0200X
Radiology Clinic/Center
Primary
5032435-0160
UT
Other
Enumeration date
06/07/2006
Last updated
02/15/2017
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