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Organization
SOUTH OGDEN SPECIALTY SURGICAL CENTER, LLC
Active
Organization
SOUTH OGDEN SPECIALTY SURGICAL CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JUSTIN BOYD COWLEY (ADMINISTRATOR)
(801) 317-4896
Entity
Organization
Contact information
Practice address
955 CHAMBERS ST, SUITE 101, SOUTH OGDEN, UT 84403-4595
(801) 317-4896
(801) 605-8226
Mailing address
955 CHAMBERS ST, SUITE 101, SOUTH OGDEN, UT 84403-4595
(801) 317-4896
(801) 605-8226
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
NULL
Other
Enumeration date
01/24/2014
Last updated
10/20/2014
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