Organization
MALE FERTILITY AND PEYRONIE'S CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LANDON TROST MD (OWNER, MD)
(801) 655-0015
Entity
Organization
Contact information
Practice address
1443 W 800 N STE 302, OREM, UT 84057-2883
(801) 655-0015
(801) 655-0048
Mailing address
1443 W 800 N STE 302, OREM, UT 84057-2883
(801) 655-0015
(801) 655-0048
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
09/11/2020
Last updated
05/12/2021
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