Organization
AXON IOM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DALLAS WARD CNIM, DC (MEMBER/ REGISTERED AGENT)
(385) 245-3580
Entity
Organization
Contact information
Practice address
1110 E 400 N, KAYSVILLE, UT 84037-1754
(385) 245-3580
Mailing address
1110 E 400 N, KAYSVILLE, UT 84037-1754
(385) 245-3580
Taxonomy
Speciality
Code
Description
License number
State
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
—
—
Other
Enumeration date
04/11/2019
Last updated
01/23/2023
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