NPI 1215057955

Intermountain Spine and Pain Center

Organisation Ambulatory Surgical Clinic/Center Providence, UT

Practice location

Address: 286 N Gateway Dr, Providence, UT 84332-9733
Phone: (435) 753-1600
Fax: (435) 753-9521
Mailing address: 274 N Main St, Logan, UT 84321-3915

Authorised official

Name: Tracey H Kartsone
Title: Accounts Manager
Phone: (435) 753-1600

Registered specialties

Ambulatory Surgical Clinic/Center Primary

Ambulatory Health Care Facilities Taxonomy 261QA1903X Licence 0329116-1204 (UT)

Other Clinic/Center providers in Utah →

Registry record

NPI: 1215057955
Entity type: Organization
NPI issued: 29 Mar 2007
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.