Organization Name: | INTERMOUNTAIN MEDICAL GROUP, INC |
NPI Number: | 1356397673 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DONNA POWELL (CHIEF OPERATING OFFICER) |
Mailing Address: | 610 Wyoming Ave Kingston |
State: | PA US |
Postal Code: | 187043702 |
Phone Number: | 5702885441 |
Fax Number: | 5702885842 |
NPI Enumeration Date: | 05/26/2006 |
NPI Last Update Date: | 01/28/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |