| Imed Utah Heart - Jackson | |
|
625 E Broadway Jackson WY 83001-0000 | |
| (801) 507-3500 | |
| Not Available |
| Full Name | Imed Utah Heart - Jackson |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 625 E Broadway, Jackson, Wyoming |
| Authorized Official Name and Position | Kelly J Howard (DIRECTOR) |
| Authorized Official Contact | 8014421425 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Imed Utah Heart - Jackson Po Box 27128 Salt Lake City UT 84127-0128 Ph: (801) 507-3533 | Imed Utah Heart - Jackson 625 E Broadway Jackson WY 83001-0000 Ph: (801) 507-3500 |
| NPI Number | 1396979159 |
|---|---|
| Provider Enumeration Date | 05/08/2009 |
| Last Update Date | 05/08/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396979159 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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