Provider Demographics
NPI:1679645139
Name:WASATCH IMAGING LLC
Entity Type:Organization
Organization Name:WASATCH IMAGING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:M
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-232-6457
Mailing Address - Street 1:9844 S 1300 E
Mailing Address - Street 2:#175
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84094-4688
Mailing Address - Country:US
Mailing Address - Phone:801-576-1290
Mailing Address - Fax:801-572-7629
Practice Address - Street 1:9844 S 1300 E
Practice Address - Street 2:#175
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84094-4688
Practice Address - Country:US
Practice Address - Phone:801-576-1290
Practice Address - Fax:801-572-7629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)