Organization
ADVANCED VEIN AND VASCULAR OF NORTHERN UTAH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYNSEY NIELSEN (OFFICE MANAGER)
(385) 388-8003
Entity
Organization
Contact information
Practice address
1515 N 400 E STE 106, NORTH LOGAN, UT 84341-7595
(385) 388-8003
(385) 344-4006
Mailing address
6321 S REDWOOD RD STE 102, TAYLORSVILLE, UT 84123-6799
(385) 388-8003
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
—
—
Other
Enumeration date
09/02/2020
Last updated
08/08/2022
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