Organization
K & C ENTERPISES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLARK C LARSEN M.D. (OWNER)
(801) 554-0199
Entity
Organization
Contact information
Practice address
445 E MAPLEBERRY CT, DRAPER, UT 84020-6860
(801) 554-0199
Mailing address
445 E MAPLEBERRY CT, DRAPER, UT 84020-6860
(801) 554-0199
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
09/21/2015
Last updated
09/21/2015
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