Individual
MR. CHARLES JOSEPH GOSSELIN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 FOOTHILL BLVD, SALT LAKE CITY, UT 84148-0001
(801) 584-1240
Mailing address
7952 OAKLEDGE RD, SALT LAKE CITY, UT 84121-5823
(801) 947-9032
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R 035332
ME
Other
Enumeration date
09/06/2006
Last updated
07/08/2007
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