Organization
FAMILY SURGICAL SUITE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN JAN DEHART (MANAGING MEMBER)
(801) 495-1064
Entity
Organization
Contact information
Practice address
8822 S REDWOOD RD, SUITE 113, WEST JORDAN, UT 84088-9336
(801) 495-1064
(801) 523-1139
Mailing address
8822 S REDWOOD RD, SUITE 113, WEST JORDAN, UT 84088-9336
(801) 495-1064
(801) 523-1139
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
12/18/2007
Last updated
12/18/2007
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