Organization
INTRAOPERATIVE MONITORING ASSOC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NICK LUEKENGA (OWNER)
(801) 920-1171
Entity
Organization
Contact information
Practice address
1817 W. 800 N, SALT LAKE CITY, UT 84025
(505) 836-7894
(888) 315-4512
Mailing address
8400 MENAUL BLVD. A211, ALBUQUERQUE, NM 87112-2260
(505) 836-7894
(888) 315-4512
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
05/13/2010
Last updated
09/18/2012
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