Organization
CENTRAL UTAH FOOT CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK ROGERS (OWNER)
(801) 756-4200
Entity
Organization
Contact information
Practice address
120 N 1220 E, STE 12, AMERICAN FORK, UT 84003-2089
(801) 756-4200
(801) 756-8252
Mailing address
120 N 1220 E, STE 12, AMERICAN FORK, UT 84003-2089
(801) 756-4200
(801) 756-8252
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
102652-0501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1881729507
NPI
—
Enumeration date
09/20/2012
Last updated
09/20/2012
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