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Individual

SPENCER POULSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
652 S MEDICAL CENTER DR # 420, ST GEORGE, UT 84790-7049
(435) 251-6800
Mailing address
652 S MEDICAL CENTER DR # 420, ST GEORGE, UT 84790-7049
(435) 251-6800

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
363LF0000X
Family Nurse Practitioner
Primary
8336759-4405
UT

Other

Enumeration date
07/20/2010
Last updated
10/12/2020
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