Organization
INTERMOUNTAIN HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NEIL WHITAKER MD (MEDICAL DIRECTOR)
(801) 357-2549
Entity
Organization
Contact information
Practice address
1034 N 500 W, PROVO, UT 84604-3380
(801) 357-8117
Mailing address
1034 N 500 W, PROVO, UT 84604-3380
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
52296918900
UT
Other
Enumeration date
11/30/2011
Last updated
11/30/2011
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