Individual
TALMAGE LEE BOURNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3725 W 4100 SOUTH, WEST VALLEY CITY, UT 84120
(801) 965-3600
(801) 965-3526
Mailing address
3725 W 4100 SOUTH, WEST VALLEY CITY, UT 84120
(801) 965-3600
(801) 965-3526
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1538921205
UT
Other
Enumeration date
07/07/2006
Last updated
05/13/2013
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