Organization
COTTONWOOD SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLARK LARSEN DPM (CEO)
(801) 261-1391
Entity
Organization
Contact information
Practice address
6053 S FASHION SQUARE DR, SUITE # 100, MURRAY, UT 84107-5439
(801) 262-0098
Mailing address
6053 S FASHION SQUARE DR, SUITE # 100, MURRAY, UT 84107-5439
(801) 262-0098
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
07/01/2010
Last updated
03/03/2011
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