Organization
UTAH VALLEY RADIOLOGY ASSOC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANELL BURGON (CREDENTIALING)
(801) 701-6504
Entity
Organization
Contact information
Practice address
380 W. 100 N., MONTICELLO, UT 84535
(801) 225-6246
Mailing address
283 E 930 S, OREM, UT 84058-5001
(801) 225-6246
(801) 225-1525
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
87028448008
—
UT
Enumeration date
03/21/2011
Last updated
03/21/2011
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