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Individual

LORELL B FAWSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
3590 HARRISON BLVD, G1, OGDEN, UT 84403
(801) 627-2122
(801) 627-2125
Mailing address
3590 HARRISON BLVD, G1, OGDEN, UT 84403
(801) 627-2122
(801) 627-2125

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
1030720501
UT

Other

Enumeration date
01/18/2006
Last updated
12/04/2007
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