OrganizationActive
Kkmmcb Medical, PLLC
NPI 1033627591 · Clinical Neurophysiology Physician · Sandy, UT
Provider details
- NPI number
- 1033627591
- Entity type
- Organization
- Primary specialty
- Clinical Neurophysiology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Lizette Morin, Mdms Npi Compliance Officer(210) 598-2800
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Electrodiagnostic Medicine Physician204R00000X
Allopathic & Osteopathic Physicians
- Neurology Physician2084N0400X
Allopathic & Osteopathic Physicians
Technologists, Technicians & Other Technical Service Providers
Practice location
9980 South 300 West Suite 200
Sandy, UT 84070
Phone: (385) 254-0279
Approximate (ZIP-level) locationGet directions
Mailing address
1338 S Foothill Dr #331
Salt Lake City, UT 84108-2321
Registry dates
- Enumerated
- 2018-01-18
- Last updated
- 2018-01-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.