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Individual

SPENCER VAN AUSDAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
99 S 620 E, SALEM, UT 84653-5702
(801) 244-4894
Mailing address
99 S 620 E, SALEM, UT 84653-5702

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
13977665-3102
UT

Other

Enumeration date
05/04/2026
Last updated
05/04/2026
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