Organization
LEGACY ANESTHESIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL DAGLEY CRNA (PRESIDENT)
(435) 671-1254
Entity
Organization
Contact information
Practice address
1485 S HIGHWAY 40, HEBER CITY, UT 84032-3522
(435) 654-2500
Mailing address
PO BOX 3750, SALT LAKE CITY, UT 84110-3750
(800) 748-4868
(770) 701-6676
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
120505
UT
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
11/09/2015
Last updated
11/16/2016
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