Organization
LOGAN SURGICAL SUITES LLC
Active
Other names
Advanced Surgery Center of Northern Utah
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARIELLE WHITLOCK R.N. (ADMINISTRATOR)
(435) 760-3734
Entity
Organization
Contact information
Practice address
55 EAST GOLF COURSE ROAD, LOGAN, UT 84321-0001
(435) 760-3734
Mailing address
55 EAST GOLF COURSE ROAD, LOGAN, UT 84321-0001
(435) 787-7190
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
10/01/2018
Last updated
09/23/2021
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