Organization
WAYMORE SHADE LLC
Active
Other names
Summit Dermatology
Organization subpart
No
Provider details
NPI number
Authorized official
ISAAC BRYAN DO (DERMATOLOGIST)
(801) 805-4744
Entity
Organization
Contact information
Practice address
451 S MAIN ST STE 1, SPRINGVILLE, UT 84663-2293
(801) 805-4744
Mailing address
451 S MAIN ST STE 1, SPRINGVILLE, UT 84663-2293
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
04/23/2019
Last updated
04/23/2019
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