Organization
MOUNT OGDEN PAIN MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CINDIE G DODENBIER APRN (PRESIDENT)
(435) 755-9174
Entity
Organization
Contact information
Practice address
286 N GATEWAY DR, STE A, PROVIDENCE, UT 84332-9733
(435) 755-9174
(435) 755-9148
Mailing address
4520 S 900 W # 324, RIVERDALE, UT 84405-7155
(435) 753-1600
(435) 753-9521
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
5306448-1205
UT
Other
Enumeration date
05/21/2007
Last updated
08/22/2007
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