# LEGACY ANESTHESIA LLC

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

## Provider details

- **NPI number:** 1851764112
- **Authorized official:** MR. MICHAEL DAGLEY CRNA (PRESIDENT)
- **Authorized official phone:** (435) 671-1254

## Contact information

- **Practice address:** 1485 S HIGHWAY 40, HEBER CITY, UT 84032-3522
- **Practice address phone:** (435) 654-2500
- **Mailing address:** PO BOX 3750, SALT LAKE CITY, UT 84110-3750
- **Mailing address phone:** (800) 748-4868
- **Mailing address fax:** (770) 701-6676

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | 120505 | UT | Yes |
| 367500000X | Certified Registered Nurse Anesthetist | — | NULL | — |
| 367500000X | Certified Registered Nurse Anesthetist | — | — | — |

## Other

- **Enumeration date:** 11/09/2015
- **Last updated:** 11/16/2016