Individual
MARIO DAMON LA GIGLIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
802 S 200 W, BLANDING, UT 84511-3910
(435) 678-3993
(435) 678-3992
Mailing address
802 S 200 W, BLANDING, UT 84511-3910
(435) 678-3993
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
—
—
208600000X
Surgery Physician
2015-02260
NC
208600000X
Surgery Physician
Primary
9743925-1204
UT
Other
Enumeration date
06/23/2009
Last updated
04/03/2019
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