Individual
CHASETON CLARE WOMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
395 W COUGAR BLVD STE 205, PROVO, UT 84604-3328
(801) 357-1770
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
14155775-1204
UT
207QA0505X
Adult Medicine Physician
14155775-1204
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/17/2023
Last updated
02/04/2026
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