Organization
DESERT BLOOM PLASTIC SURGERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORDAN WALLIN MD (PRESIDENT)
(435) 627-8150
Entity
Organization
Contact information
Practice address
446 S MALL DR STE 1, ST GEORGE, UT 84790-4944
(435) 627-8150
Mailing address
446 S MALL DR STE 1, ST GEORGE, UT 84790-4944
(435) 627-8150
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
04/04/2019
Last updated
01/02/2025
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