CHARLES C SOUTHERLAND

EAGLE MOUNTAIN, UT
NPI1306832944
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy213ES0103X Podiatrist, Foot & Ankle Surgery
(Licence: UT  9244891-0501)
Enumeration Date2005-09-20
Last Update Date2020-04-24
Business Address
Dr. CHARLES C SOUTHERLAND DPM
3435 E PONY EXPRESS PKWY STE 140
EAGLE MOUNTAIN, UT 84005-5548
Phone number: 801-893-8811
Mailing Address
Dr. CHARLES C SOUTHERLAND DPM
11300 NE 2ND AVENUE
MIAMI SHORES, FL 33161
Phone number: 305-693-7287
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