LOGAN UROLOGY CLINIC

LOGAN, UT
NPI1326274507
Entity TypeOrganization
Authorized ContactRYAN HAROLD LARSEN
Physician
435-753-1171
Organization Subpart ?Yes
Primary Taxonomy302F00000X Exclusive Provider Organization
(Licence: UT  175141-1205)
Enumeration Date2009-06-02
Last Update Date2009-06-02
Business Address
LOGAN UROLOGY CLINIC
550 E 1400 N STE J
LOGAN, UT 84341-2406
Phone number: 435-753-1171
Mailing Address
LOGAN UROLOGY CLINIC
550 E 1400 N STE J
LOGAN, UT 84341-2406
Phone number: 435-753-1171