Tellica Imaging, LLC

NPI #1710605696 in Draper, Utah

Provider Information

NPI Number
1710605696
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 17, 2022
Last Updated
Feb 7, 2023

Practice Location

Address
195 W 13290 S
City
Draper
State
Utah
ZIP Code
84020
Phone
(801) 442-5737

Authorized Official

Name
NANNETTE MIGNON BERENSEN
Title
CEO
Phone
(801) 507-8002

Specialties & Taxonomy Codes

Specialty
Clinic/Center - RadiologyRadiology
Physiological Laboratory

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