Individual provider · NPI-1

Kiley Glenn Anderson, R.T.(R)(N)(VI) CNMT

Radiologic Technologist, Vascular-Interventional Technology · Salt Lake City, UT

NPI number1952780728
StatusActive
Last updated in NPPESMay 26, 2015

Details

NPI
1952780728
Entity type
Individual (NPI-1)
Name
Mr. Kiley Glenn Anderson
Credential
R.T.(R)(N)(VI) CNMT
Sex
Male
Sole proprietor
No
Enumeration date
May 26, 2015
Last updated
May 26, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2471V0106X Radiologic Technologist, Vascular-Interventional Technology7906934-5401UTYes

Practice location

439 Bryan Avenue
Salt Lake City, UT 84115

Phone 740-350-6281

Mailing address

439 E Bryan Ave
Salt Lake City, UT 84115-1713

Phone 740-350-6281

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