RICHARD BLAINE IVERSON

SALT LAKE CITY, UT
NPI1568788602
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology
(Licence: UT  8199146-1204)
Enumeration Date2010-04-14
Last Update Date2013-01-29
Business Address
-- RICHARD BLAINE IVERSON D.O.
1050 E SOUTH TEMPLE
SALT LAKE CITY, UT 84102-1507
Phone number: 801-350-4734
Mailing Address
-- RICHARD BLAINE IVERSON D.O.
10003 S CHIP CIR
SOUTH JORDAN, UT 84095-2781
Phone number: 801-350-4734
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