Organization
UTAH SPINE CARE, LLC
Active
Other names
Utah Spine Care
Organization subpart
No
Provider details
NPI number
Authorized official
TROY FULLER (PRACTICE ADMINISTRATOR)
(801) 732-5950
Entity
Organization
Contact information
Practice address
4403 HARRISON BLVD, STE 1815, OGDEN, UT 84403-3271
(801) 732-5950
(801) 732-5988
Mailing address
4403 HARRISON BLVD, STE 1815, OGDEN, UT 84403-3271
(801) 732-5950
(801) 732-5988
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
1835611205
UT
207T00000X
Neurological Surgery Physician
Primary
2626351205
UT
208100000X
Physical Medicine & Rehabilitation Physician
1765801205
UT
Other
Enumeration date
07/01/2011
Last updated
10/03/2016
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