Organization
LAKEVIEW NEUROSURGERY CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID J KANE (VP)
(801) 568-5999
Entity
Organization
Contact information
Practice address
620 MEDICAL DR, SUITE 300, BOUNTIFUL, UT 84010-4908
(801) 299-3871
(801) 299-3870
Mailing address
620 MEDICAL DR, SUITE 300, BOUNTIFUL, UT 84010-4908
(801) 299-3871
(801) 299-3870
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235161068
—
UT
Enumeration date
07/06/2006
Last updated
08/14/2008
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