Organization
BRIDGE CLINIC, PLLC
Active
Other names
St. George Dermatology
Organization subpart
No
Provider details
NPI number
Authorized official
TRENT KENWORTHY NP (OWNER)
(435) 313-7237
Entity
Organization
Contact information
Practice address
230 N 1680 E STE N1, ST GEORGE, UT 84790-2596
(435) 313-7237
Mailing address
230 N 1680 E STE N1, ST GEORGE, UT 84790-2596
(435) 313-7237
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
261Q00000X
Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Enumeration date
07/03/2024
Last updated
09/10/2024
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