Organization
LITTLE S CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELLEN GARDNER MD (OWNER)
(435) 559-5840
Entity
Organization
Contact information
Practice address
200 S 4200 W, PAROWAN, UT 84761-1330
(435) 559-5840
Mailing address
200 S 4200 W, PAROWAN, UT 84761-1330
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
03/07/2013
Last updated
05/02/2013
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