Organization
WASATCH NEUROLOGICAL SURGERY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRENT LEE CLYDE M.D. (OWNER)
(801) 295-2438
Entity
Organization
Contact information
Practice address
3401 S HIGHWAY 89, BOUNTIFUL, UT 84010-8517
(801) 295-2438
(866) 630-0782
Mailing address
3401 S HIGHWAY 89, BOUNTIFUL, UT 84010-8517
(801) 295-2438
(866) 630-0782
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
48219121205
UT
Other
Enumeration date
03/10/2008
Last updated
05/01/2008
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