Provider Demographics
NPI:1477886091
Name:GELTER, JUDY KAYE (RT)
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:KAYE
Last Name:GELTER
Suffix:
Gender:F
Credentials:RT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 S KAYS DR
Mailing Address - Street 2:
Mailing Address - City:KAYSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84037-4117
Mailing Address - Country:US
Mailing Address - Phone:801-593-6989
Mailing Address - Fax:
Practice Address - Street 1:419 S KAYS DR
Practice Address - Street 2:
Practice Address - City:KAYSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84037-4117
Practice Address - Country:US
Practice Address - Phone:801-593-6989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-14
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6757255-5401247100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist