# ADVANCED DYSPHAGIA DIAGNOSTICS LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ADVANCED DYSPHAGIA DIAGNOSTICS LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1558902361
- **Legal business name:** ADVANCED DYSPHAGIA DIAGNOSTICS LLC
- **Authorized official:** KIMBERLY A GEMMELL (OWNER)
- **Authorized official phone:** (909) 213-5967

## Contact information

- **Practice address:** 1465 S UTE DR, SALT LAKE CITY, UT 84108-2433
- **Practice address phone:** (909) 213-5967
- **Practice address fax:** (509) 356-4607
- **Mailing address:** 236 S 3RD ST STE 332, MONTROSE, CO 81401-3618
- **Mailing address phone:** (909) 213-5967

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 235Z00000X | Speech-Language Pathologist | — | NULL | Yes |
| 235Z00000X | Speech-Language Pathologist | — | — | Yes |

## Other

- **Enumeration date:** 10/02/2019
- **Last updated:** 10/02/2019