MR. KILEY GLENN ANDERSON (NPI# 1952780728) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952780728 |
| Entity Type | Individual |
| Full Name | MR. KILEY GLENN ANDERSON |
| Credential | R.T.(R)(N)(VI) CNMT |
| Practice Address |
439 Bryan Avenue Salt Lake City UT 84115 |
| Mailing Address |
439 E Bryan Ave Salt Lake City UT 84115-1713 |
| Practice Telephone | 7403506281 |
| Mailing Telephone | 7403506281 |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2015-05-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2471V0106X |
Radiologic Technologist Specialization: Vascular-Interventional Technology |
7906934-5401 | UT | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
439 BRYAN AVENUE |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84115 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396344198 | Shannon Ballinger | Clinic/Center | 1470 400 W, Salt Lake City, UT 84115 | 2020-10-22 |
| 1992346704 | Anicka Inc | Clinic/Center | 3195 South Main St, Ste 260, South Salt Lake, UT 84115 | 2019-10-02 |
| 1083177505 | Vitor Gabriel Giuliani Alcantara Carioca | Specialist/Technologist | 1850 South Campus Drive, Salt Lake City, UT 84115 | 2019-04-11 |
| 1427528371 | Samuel James Leonhart | Behavior Technician | 354 East Coatsville Drive, Salt Lake City, UT 84115 | 2018-12-04 |
| 1093228645 | Eco Pharmacy LLC | Pharmacy | 3702 S State Street Suite 115, South Salt Lake City, UT 84115 | 2017-11-06 |
| 1568973055 | Eco Apothecary LLC | Pharmacy | 3701 S State Street Suite 114, South Salt Lake City, UT 84115 | 2017-10-24 |
| 1548780455 | Kelly Lund | Case Manager/Care Coordinator | 447 W. Bearcat Dr., Salt Lake City, UT 84115 | 2017-06-21 |
| 1104271238 | The Church of Philadelphia Inc. | Community/Behavioral Health | 2358 South Main Street, Salt Lake City, UT 84115 | 2016-04-26 |
| 1710368626 | Jennifer Swanhild Edwards | Counselor | 140 W 2100 S Ste 244, Salt Lake City, UT 84115 | 2015-06-16 |
| 1508247065 | John Mcguire | Health Educator | 1370 S. West Temple, Salt Lake City, UT 84115 | 2015-06-10 |
| Find all providers in zip 84115 | ||||
| Taxonomy Code | 2471V0106X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Radiologic Technologist |
| Specialization | Vascular-Interventional Technology |
| Definition to come. |
| City | SALT LAKE CITY |
| Zip Code | 84115 |
Please comment or provide details below to improve the information on MR. KILEY GLENN ANDERSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.