Organization
MEDELA WOUND CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH CLARK FYANS MD (OWNER)
(801) 440-3034
Entity
Organization
Contact information
Practice address
2230 N UNIVERSITY PKWY STE 6B, PROVO, UT 84604-1584
(801) 440-3034
Mailing address
5064 N RAVENCREST LN, LEHI, UT 84043-7725
(801) 440-3034
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
10/02/2019
Last updated
10/02/2019
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