Organization
PINE TOP MEDICAL P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EUGENE DOUGLAS LARSEN JR. D.O. (PRESIDENT)
(801) 309-5156
Entity
Organization
Contact information
Practice address
284 N HOSPITAL DR, SUITE 2, PRICE, UT 84501-4233
(435) 637-5690
(435) 637-9809
Mailing address
284 N HOSPITAL DR, SUITE 2, PRICE, UT 84501-4233
(435) 637-5690
(435) 637-9809
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
93369771204
UT
Other
Enumeration date
06/29/2015
Last updated
08/10/2015
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