Organization
WASATCH ANESTHESIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY THOMAS CRNA (CRNA/ OWNER)
(435) 753-1600
Entity
Organization
Contact information
Practice address
65 N GATEWAY DR STE 3, PROVIDENCE, UT 84332-6102
(435) 535-3257
Mailing address
560 W 465 N STE 604, PROVIDENCE, UT 84332-8006
(435) 753-1600
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
01/14/2025
Last updated
01/14/2025
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