Individual
MR. JUSTIN RICHARD DEGOOYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
4401 HARRISON BLVD, OGDEN, UT 84403-3195
(385) 259-2714
Mailing address
1333 FOX POINTE DR, KAYSVILLE, UT 84037-4060
(385) 259-2714
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
9421639-3102
UT
363LF0000X
Family Nurse Practitioner
Primary
9421639-4405
UT
Other
Enumeration date
07/31/2020
Last updated
08/28/2020
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