Organization
SOUTH OGDEN SPECIALTY SURGICAL CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JUSTIN BOYD COWLEY (ADMINISTRATOR)
(801) 317-4896
Entity
Organization
Contact information
Practice address
955 CHAMBERS ST, SUITE 101, SOUTH OGDEN, UT 84403-4595
(801) 317-4896
(801) 605-8226
Mailing address
955 CHAMBERS ST, SUITE 101, SOUTH OGDEN, UT 84403-4595
(801) 317-4896
(801) 605-8226
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
01/24/2014
Last updated
10/20/2014
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