Organization
IPS OF UTAH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARL R, NOBACK MD (MEMBER)
(941) 360-1566
Entity
Organization
Contact information
Practice address
11800 S. STATE ST, DRAPER, UT 84020
(801) 316-1313
Mailing address
PO BOX 864483, ORLANDO, FL 32886-4483
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
06/24/2009
Last updated
06/24/2009
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