East Side Imaging, LLC
NPI #1316425432 in South Salt Lake, Utah
Provider Information
- NPI Number
- 1316425432
- Entity Type
- Organization
- Organization Name
- East Side Imaging, LLC
- Primary Specialty
- Physiological Laboratory
- Enumeration Date
- Jul 31, 2018
- Last Updated
- Aug 11, 2021
Practice Location
- Address
- 3702 S STATE ST STE 111
- City
- South Salt Lake
- State
- Utah
- ZIP Code
- 84115-5078
- Phone
- (801) 288-9671
Authorized Official
- Name
- ALBERT C. VAN KIRK
- Title
- PRESIDENT AND CEO
- Phone
- (330) 653-3968
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physiological Laboratory |
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