Organization
PHYSICIAN GROUP OF UTAH INC
Active
Other names
PGUT Wyoming
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE M. ROGERS (MANAGER/CMS DELEGATED OFFICIAL)
(617) 562-5628
Entity
Organization
Contact information
Practice address
1577 DEWAR DR STE 8, ROCK SPRINGS, WY 82901-5716
(307) 362-0707
Mailing address
9 GALEN ST, WATERTOWN, MA 02472-4515
(617) 562-5628
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Enumeration date
04/10/2020
Last updated
04/10/2020
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