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1417525544
SAMUEL MARK BERTOCH
ROOSEVELT, UT
NPI
1417525544
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: UT 327174-4405)
Enumeration Date
2021-06-15
Last Update Date
2021-06-15
Business Address
MR. SAMUEL MARK BERTOCH FNP-C
2750 NORTH 2762 WEST
ROOSEVELT, UT 84066
Phone number: 435-722-9250
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Mailing Address
MR. SAMUEL MARK BERTOCH FNP-C
2750 NORTH 2762 WEST
ROOSEVELT, UT 84066
Phone number: 435-722-9250
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