Organization
MOUNTAINSTAR CARDIOVASCULAR SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KIRT L. PETERSON (ADMINISTRATOR)
(801) 743-4750
Entity
Organization
Contact information
Practice address
698 W 800 N, SUITE #210, OREM, UT 84057-3658
(801) 714-6412
(801) 714-6413
Mailing address
698 W 800 N, SUITE #210, OREM, UT 84057-3658
(801) 714-6412
(801) 714-6413
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Enumeration date
11/16/2007
Last updated
11/16/2007
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