Organization
ADVANCED DYSPHAGIA DIAGNOSTICS LLC
Active
Parent organization
ADVANCED DYSPHAGIA DIAGNOSTICS LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ADVANCED DYSPHAGIA DIAGNOSTICS LLC
Authorized official
KIMBERLY A GEMMELL (OWNER)
(909) 213-5967
Entity
Organization
Contact information
Practice address
1465 S UTE DR, SALT LAKE CITY, UT 84108-2433
(909) 213-5967
(509) 356-4607
Mailing address
236 S 3RD ST STE 332, MONTROSE, CO 81401-3618
(909) 213-5967
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
10/02/2019
Last updated
10/02/2019
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