Organization
CANYON RIDGE PAIN AND SPINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAUL KEM WESTON MD (PRESIDENT)
(801) 205-4116
Entity
Organization
Contact information
Practice address
1551 RENAISSANCE TOWNE DR, SUITE 460, BOUNTIFUL, UT 84010-7667
(801) 205-4116
(435) 986-9368
Mailing address
1551 RENAISSANCE TOWNE DR, SUITE 460, BOUNTIFUL, UT 84010-7667
(801) 205-4116
(435) 986-9368
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
6955001-1205
UT
Other
Enumeration date
07/22/2011
Last updated
07/22/2011
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