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1053060939
SAMANTHA BENGTZEN DERZON
PROVO, UT
NPI
1053060939
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2022-03-19
Last Update Date
2022-03-19
Business Address
SAMANTHA BENGTZEN DERZON MD
475 W 940 N
PROVO, UT 84604-3301
Phone number: 801-357-7940
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Mailing Address
SAMANTHA BENGTZEN DERZON MD
475 W 940 N
PROVO, UT 84604-3301
Phone number:
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