OrganizationActive
Western Intermountain Lithotripsy
NPI 1679767834 · Lithotripsy Clinic/Center · Logan, UT
Provider details
- NPI number
- 1679767834
- Entity type
- Organization
- Primary specialty
- Lithotripsy Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- David Kooyman, Ceo/Business Manager(435) 757-6264
- License
- 2055 (UT)
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
862 Garden Cir
Logan, UT 84321-6465
Phone: (801) 964-1200
Fax: (801) 964-1344
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 160515
Clearfield, UT 84016-0515
Registry dates
- Enumerated
- 2007-08-30
- Last updated
- 2013-08-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.