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Organization
TOOELE UROLOGY LLC
Active
Organization
TOOELE UROLOGY LLC
Active
Parent organization
UROLOGIC SURGERY ASSOCIATES
Organization subpart
Yes
Provider details
NPI number
Legal business name
UROLOGIC SURGERY ASSOCIATES
Authorized official
DR. DAN HIBBERT MD (MANAGER)
(801) 822-2727
Entity
Organization
Contact information
Practice address
11179 IVY CREEK CV, SOUTH JORDAN, UT 84095-2249
(801) 822-2727
Mailing address
11179 IVY CREEK CV, SOUTH JORDAN, UT 84095-2249
(801) 822-2727
Taxonomy
Speciality
Code
Description
License number
State
261QL0400X
Lithotripsy Clinic/Center
7100427-1205
UT
261QM2500X
Medical Specialty Clinic/Center
Primary
7100427-1205
UT
Other
Enumeration date
01/21/2009
Last updated
09/25/2019
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