Organization Name: | SLEEP INSTITUTE OF UTAH LLC |
NPI Number: | 1083701601 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JEANETTE DENISE ROBINS (MEMBER MANAGER) |
Mailing Address: | 1464 E Ridgeline Dr Ste 104 South Ogden |
State: | UT US |
Postal Code: | 844054998 |
Phone Number: | 8012542895 |
Fax Number: | 8012544715 |
NPI Enumeration Date: | 10/06/2006 |
NPI Last Update Date: | 03/09/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QS1200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Sleep Disorder Diagnostic |
Taxonomy Definition: |