Individual
CLINTON DANIEL LAURIDSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
98 N 1100 E STE 102, AMERICAN FORK, UT 84003-2940
(801) 492-2550
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 492-2550
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9054956-1204
UT
Other
Enumeration date
08/23/2011
Last updated
06/16/2020
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