Organization
SURGICAL SPECIALISTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATE MILLER (OWNER)
(208) 287-9420
Entity
Organization
Contact information
Practice address
10 W SCENIC POINTE DR STE 102, DRAPER, UT 84020-6124
(208) 287-9420
Mailing address
1988 W 930 N STE D, PLEASANT GROVE, UT 84062-4132
(208) 287-9420
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
823959813
TAX ID
UT
Enumeration date
04/10/2018
Last updated
04/10/2018
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