Individual provider · NPI-1
Brandon Bargeloh
Radiologic Technologist, Computed Tomography · Salt Lake City, UT
NPI number1407438104
StatusActive
Last updated in NPPESApr 22, 2021
Details
- NPI
- 1407438104
- Entity type
- Individual (NPI-1)
- Name
- Brandon Bargeloh
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 22, 2021
- Certification date
- Apr 22, 2021
- Last updated
- Apr 22, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2471C3401X | Radiologic Technologist, Computed Tomography | 506506 | – | Yes |
Practice location
500 Foothill DrSalt Lake City, UT 84148-0001
Phone 801-582-1565
Mailing address
1530 Kenny RdColumbus, OH 43212-2563
Phone 740-706-6942
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