Individual
MR. KILEY GLENN ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.T.(R)(N)(VI) CNMT
Contact information
Practice address
439 BRYAN AVENUE, SALT LAKE CITY, UT 84115
(740) 350-6281
Mailing address
439 E BRYAN AVE, SALT LAKE CITY, UT 84115-1713
(740) 350-6281
Taxonomy
Speciality
Code
Description
License number
State
2471V0106X
Vascular-Interventional Technology Radiologic Technologist
Primary
7906934-5401
UT
Other
Enumeration date
05/26/2015
Last updated
05/26/2015
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