Organization
INTERMOUNTAIN HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEIDI NICOLE BAGLEY R.D. (CLINICAL DIETITIAN)
(801) 662-5318
Entity
Organization
Contact information
Practice address
100 N MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113-1103
(801) 662-5318
Mailing address
100 N MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113-1103
Taxonomy
Speciality
Code
Description
License number
State
282NC2000X
Children's Hospital
Primary
78229114901
UT
Other
Enumeration date
08/18/2016
Last updated
08/18/2016
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