Organization
CORAL DESERT SPINE SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RYAN D CHURCH FNP-C (OWNER)
(435) 656-8366
Entity
Organization
Contact information
Practice address
1490 E FOREMASTER DR STE 220, ST GEORGE, UT 84790-4498
(435) 656-8366
(435) 656-8370
Mailing address
1490 E FOREMASTER DR STE 220, ST GEORGE, UT 84790-4498
(435) 656-8366
(435) 656-8370
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
5064080-1205
UT
Other
Enumeration date
06/22/2011
Last updated
09/11/2012
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