Organization
BRAIN INJURY ASSOCIATION OF UTAH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RON S. ROSKOS (EXECUTIVE DIRECTOR)
(801) 484-2240
Entity
Organization
Contact information
Practice address
1800 S WEST TEMPLE, SUITE 203, SALT LAKE CITY, UT 84115-1851
(801) 484-2240
(801) 484-5932
Mailing address
1800 S WEST TEMPLE, SUITE 203, SALT LAKE CITY, UT 84115-1851
(801) 484-2240
(801) 484-5932
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
N10744
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2935
—
UT
Enumeration date
01/02/2007
Last updated
08/22/2020
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