# BLASER MEDICAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023721941
- **Authorized official:** ELIZABETH ANN ALLISON (CONTRACTING/CREDENTIALING)
- **Authorized official phone:** (801) 391-6617

## Contact information

- **Practice address:** 475 40TH ST STE 111, OGDEN, UT 84403-1856
- **Practice address phone:** (801) 515-7997
- **Practice address fax:** (385) 333-7413
- **Mailing address:** 116 S SHADOW BREEZE RD, KAYSVILLE, UT 84037-9401
- **Mailing address phone:** (801) 515-7997
- **Mailing address fax:** (385) 333-7413

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/05/2023
- **Last updated:** 04/15/2024