# IPS OF UTAH LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568690998
- **Authorized official:** CARL R, NOBACK MD (MEMBER)
- **Authorized official phone:** (941) 360-1566

## Contact information

- **Practice address:** 11800 S. STATE ST, DRAPER, UT 84020
- **Practice address phone:** (801) 316-1313
- **Mailing address:** PO BOX 864483, ORLANDO, FL 32886-4483

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | Yes |
| 207L00000X | Anesthesiology Physician | — | — | Yes |
| 367500000X | Certified Registered Nurse Anesthetist | — | NULL | — |
| 367500000X | Certified Registered Nurse Anesthetist | — | — | — |

## Other

- **Enumeration date:** 06/24/2009
- **Last updated:** 06/24/2009