OrganizationActive
Advanced Vein and Vascular of Northern Utah LLC
NPI 1700490133 · Interventional Cardiology Physician · North Logan, UT
Provider details
- NPI number
- 1700490133
- Entity type
- Organization
- Primary specialty
- Interventional Cardiology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Lynsey Nielsen, Office Manager(385) 388-8003
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
1515 N 400 E Ste 106
North Logan, UT 84341-7595
Phone: (385) 388-8003
Fax: (385) 344-4006
Approximate (ZIP-level) locationGet directions
Mailing address
6321 S Redwood Rd Ste 102
Taylorsville, UT 84123-6799
Additional practice locations (2)
- 810 S 100 W Ste aLogan, UT 84321-6093Phone: (385) 388-8003Fax: (385) 344-4006
- 810 S 100 W Ste 120Logan, UT 84321-5845Phone: (385) 388-8003Fax: (385) 344-4006
Registry dates
- Enumerated
- 2020-09-02
- Last updated
- 2022-08-08
- Certified
- 2022-08-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.