Organization
DR ROBERT M MISKA LLC
Active
Other names
Rocky Mtn Neurology
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER DAWSON (CLINIC MANAGER)
(801) 208-5945
Entity
Organization
Contact information
Practice address
370 9TH AVE, SUITE 106, SALT LAKE CITY, UT 84103-2877
(801) 208-5945
Mailing address
PO BOX 95970, SOUTH JORDAN, UT 84095-0970
(801) 352-9500
(801) 352-9502
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
184986-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
130005996
RAILROAD MEDICARE
UT
05
—
1881876944
—
UT
Enumeration date
11/30/2007
Last updated
10/09/2008
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