Tellica Imaging, LLC
NPI #1649998709 in Salt Lake City, Utah
Provider Information
- NPI Number
- 1649998709
- Entity Type
- Organization
- Organization Name
- Tellica Imaging, LLC
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- INTERMOUNTAIN HEALTHCARE
- Primary Specialty
- Physiological Laboratory
- Enumeration Date
- Aug 16, 2022
- Last Updated
- Feb 7, 2023
Practice Location
- Address
- 2645 E PARLEYS WAY
- City
- Salt Lake City
- State
- Utah
- ZIP Code
- 84109-1636
- Phone
- (801) 442-5737
Authorized Official
- Name
- NANNETTE MIGNON BERENSEN
- Title
- CEO
- Phone
- (801) 507-8002
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Radiology — Radiology |
| Physiological Laboratory |
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