| Organization Name: | PHYSICIANS ADVANCED INTEGRATED NETWORK, LLC |
| NPI Number: | 1184873960 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARK A SNOW (MANAGER) |
| Mailing Address: | 3536 S 5600 W Suite 3 West Valley City |
| State: | UT US |
| Postal Code: | 841202788 |
| Phone Number: | 8019551555 |
| Fax Number: | 8019551552 |
| NPI Enumeration Date: | 09/16/2008 |
| NPI Last Update Date: | 04/01/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | 114566-1202 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | UT |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |