Intermountain Vein Center

NPI #1104959758 in Provo, Utah

Provider Information

NPI Number: 1104959758
Entity Type: Organization
Organization Name: Intermountain Vein Center
Primary Specialty: Specialist
Enumeration Date: Mar 13, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 1055 N 300 W
Address 2: #308
City: Provo
State: Utah
ZIP Code: 84604-3344
Phone: (801) 379-6700

Authorized Official

Name: L. JAMES JENSEN JR.
Title: COO
Phone: (801) 225-6246

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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