Intermountain Vien Center-Draper

NPI #1972628741 in Draper, Utah

Provider Information

NPI Number: 1972628741
Entity Type: Organization
Organization Name: Intermountain Vien Center-Draper
Primary Specialty: Specialist
Enumeration Date: Mar 20, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 11616 S STATE ST STE 1501
City: Draper
State: Utah
ZIP Code: 84020-7125
Phone: (801) 495-2100

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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