Organization
INTERMOUNTAIN ALLERGY & IMMUNOLOGY CLINIC
Active
Other names
Intermountain Allergy & Asthma
Organization subpart
No
Provider details
NPI number
Authorized official
DUANE HARRIS M.D. (PARTNER)
(801) 553-1900
Entity
Organization
Contact information
Practice address
12422 S 450 E, SUITE C, DRAPER, UT 84020-8050
(801) 553-1900
(801) 553-9995
Mailing address
12422 S 450 E, SUITE C, DRAPER, UT 84020-8050
(801) 553-1900
(801) 553-9995
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DD5679
GROUP RAILROAD MEDICARE
—
Enumeration date
09/06/2006
Last updated
02/20/2014
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