Dean Allen Holloway, IDMT
Individual provider Active NPI Other Technician · Farr West, UT
NPI 1962646489 · NPPES record last updated Apr 28, 2009
Key facts
- NPI
- 1962646489
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Other Technician 247200000X
- Practice address
- 3721 N Higley Rd
Farr West, UT 84404-9606 - Phone
- (801) 586-9693
- NPI assigned
- Apr 28, 2009
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Other Technician | 247200000X | Yes |
Addresses
Primary practice location
3721 N Higley Rd
Farr West, UT 84404-9606
Mailing address
3721 N Higley Rd
Farr West, UT 84404-9606
Phone (801) 586-9693
Other providers in Farr West, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 28, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.