Advanced Vein And Vascular Of Salt Lake City LLC
Internal Medicine, Interventional Cardiology in Salt Lake City, UT. Organization (NPI-2).
NPI number1386272755
StatusActive
Last updated in NPPESAug 22, 2023
Details
- NPI
- 1386272755
- Entity type
- Organization (NPI-2)
- Legal business name
- Advanced Vein And Vascular Of Salt Lake City LLC
- Organization subpart
- No
- Enumeration date
- Mar 31, 2020
- Certification date
- Aug 22, 2023
- Last updated
- Aug 22, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207RI0011X | Internal Medicine, Interventional Cardiology | – | – | Yes |
| 213ES0103X | Podiatrist, Foot & Ankle Surgery | – | – |
Practice location
6321 S Redwood Rd Ste 102Salt Lake City, UT 84123-6799
Phone 385-388-8003 · Fax 385-344-4006
Mailing address
6321 S Redwood Rd Ste 102Salt Lake City, UT 84123-6799
Phone 385-388-8003 · Fax 385-344-4006
Authorized official
Lynsey Nielsen
Clinical Administrator
3853888003
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