TERRY RUSSELL VAN WORMER

LAYTON, UT
NPI1467439505
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
Enumeration Date2005-12-29
Last Update Date2022-07-21
Business Address
-- TERRY RUSSELL VAN WORMER PA-C
2121 N 1700 W
LAYTON, UT 84041-8803
Phone number: 801-773-4840
Mailing Address
-- TERRY RUSSELL VAN WORMER PA-C
PO BOX 337
LAYTON, UT 84041-0337
Phone number: 801-773-4840
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