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Organization
LOGAN SURGICAL SUITES LLC
Active
Organization
LOGAN SURGICAL SUITES LLC
Active
Other names
Advanced Surgery Center of Northern Utah
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARIELLE WHITLOCK R.N. (ADMINISTRATOR)
(435) 760-3734
Entity
Organization
Contact information
Practice address
55 EAST GOLF COURSE ROAD, LOGAN, UT 84321-0001
(435) 760-3734
Mailing address
55 EAST GOLF COURSE ROAD, LOGAN, UT 84321-0001
(435) 787-7190
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
NULL
Other
Enumeration date
10/01/2018
Last updated
09/23/2021
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