Individual
RAULON VAN TASSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8606 N 11600 W, THATCHER, UT 84337-9103
(435) 854-7295
Mailing address
PO BOX 526, BRIGHAM CITY, UT 84302-0526
(435) 538-5061
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
12/21/2010
Last updated
12/21/2010
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