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CANYON RIDGE PAIN AND SPINE PC NPI 1376821587


NPI Information

NPI: 1376821587
Provider Name: CANYON RIDGE PAIN AND SPINE PC
Classification: Pain Medicine - 208VP0014X
Entity Type: Organization

Specialization: Interventional Pain Medicine

Address:
1551 RENAISSANCE TOWNE DR
SUITE 460
BOUNTIFUL, UT
ZIP 84010
Phone: (801) 205-4116
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CANYON RIDGE PAIN AND SPINE PC is an interventional pain medicine pain medicine in Bountiful, UT. The provider is interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. CANYON RIDGE PAIN AND SPINE PC NPI is 1376821587. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1551 RENAISSANCE TOWNE DR
SUITE 460
BOUNTIFUL, UT
ZIP 84010-667
Phone: (801) 205-4116
Fax: (435) 986-9368

The provider's authorized official is Raul Kem Weston .
The authorized official title is President and has the following contact phone number (801) 205-4116.

The enumeration date for this NPI number is 7/22/2011 and was last updated on 7/22/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208VP0014XPain MedicineInterventional Pain Medicine6955001-1205UTAHYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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