Provider Demographics
NPI:1588732309
Name:CEDAR ORTHOPAEDIC BONE DENSITOMETRY
Entity type:Organization
Organization Name:CEDAR ORTHOPAEDIC BONE DENSITOMETRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-865-9293
Mailing Address - Street 1:1335 NORTHFIELD RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84720-9390
Mailing Address - Country:US
Mailing Address - Phone:435-865-9293
Mailing Address - Fax:435-867-9848
Practice Address - Street 1:1335 NORTHFIELD RD
Practice Address - Street 2:SUITE 100
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84720-9390
Practice Address - Country:US
Practice Address - Phone:435-865-9293
Practice Address - Fax:435-867-9848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2228261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology