Individual
DR. GARY R SANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1034 N 500 W, PROVO, UT 84604-3380
(801) 373-7850
Mailing address
312 N 700 E, PLEASANT GROVE, UT 84062-2448
(801) 785-5785
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
4645
AZ
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
6949058-1204
UT
Other
Enumeration date
07/12/2007
Last updated
10/02/2008
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