Basic Information
| Provider Information | |||||||||
| NPI: | 1609973783 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MOUNTAIN VALLEY IMAGING OF UTAH LLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 470 | ||||||||
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| City: | OGDEN | ||||||||
| State: | UT | ||||||||
| PostalCode: | 844020470 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8016216671 | ||||||||
| FaxNumber: | 8016276679 | ||||||||
| Practice Location | |||||||||
| Address1: | 2910 WASHINGTON BLVD | ||||||||
| Address2: | |||||||||
| City: | OGDEN | ||||||||
| State: | UT | ||||||||
| PostalCode: | 844013751 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8016216671 | ||||||||
| FaxNumber: | 8016276679 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/20/2006 | ||||||||
| LastUpdateDate: | 03/25/2008 | ||||||||
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| AuthorizedOfficialLastName: | EMPEY | ||||||||
| AuthorizedOfficialFirstName: | CURTIS | ||||||||
| AuthorizedOfficialMiddleName: | B | ||||||||
| AuthorizedOfficialTitleorPosition: | BUSINESS MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 8016214941 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | 1702781205 | UT | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.