Western Intermountain Lithotripsy

NPI #1679767834 in Logan, Utah

Provider Information

NPI Number
1679767834
Entity Type
Organization
Organization Name
Western Intermountain Lithotripsy
Primary Specialty
Clinic/Center - Lithotripsy
Enumeration Date
Aug 30, 2007
Last Updated
Aug 7, 2013

Practice Location

Address
862 GARDEN CIR
City
Logan
State
Utah
ZIP Code
84321-6465
Phone
(801) 964-1200

Authorized Official

Name
MR. DAVID NEIL KOOYMAN
Title
CEO/BUSINESS MANAGER
Phone
(435) 757-6264

Specialties & Taxonomy Codes

Specialty
Clinic/Center - LithotripsyLithotripsy

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