LARS BERGESON

PROVIDENCE, UT
NPI1497721195
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: UT  170371-1205)
Enumeration Date2006-02-23
Last Update Date2009-11-09
Business Address
Dr. LARS BERGESON M.D.
382 W 280 N
PROVIDENCE, UT 84332-9707
Phone number: 435-752-0330
Mailing Address
Dr. LARS BERGESON M.D.
PO BOX 609
PROVIDENCE, UT 84332-0609
Phone number: 435-752-0330
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