Organization
STONE MOUNTAIN SURGICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BLAKE SEIFERS (OWNER)
(801) 571-2295
Entity
Organization
Contact information
Practice address
6804 S 1300 E, COTTONWOOD HEIGHTS, UT 84121-2882
(801) 571-2295
(801) 206-3770
Mailing address
6905 S 1300 E STE 161, MIDVALE, UT 84047-1817
(801) 571-2295
(801) 206-3770
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
UT
Other
Enumeration date
03/29/2018
Last updated
03/29/2018
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