Provider Demographics
NPI:1538342290
Name:SOUTH VALLEY NEUROLOGICAL ASSOCIATES P.C
Entity type:Organization
Organization Name:SOUTH VALLEY NEUROLOGICAL ASSOCIATES P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SEEMA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDHU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-501-8233
Mailing Address - Street 1:9844 S 1300 E
Mailing Address - Street 2:STE 125
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84094-4673
Mailing Address - Country:US
Mailing Address - Phone:801-501-8233
Mailing Address - Fax:801-501-8243
Practice Address - Street 1:9844 S 1300 E
Practice Address - Street 2:STE 125
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84094-4673
Practice Address - Country:US
Practice Address - Phone:801-501-8233
Practice Address - Fax:801-501-8243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-17
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT380452-1205204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Single Specialty