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1578852174
LANCE DUSTIN ROBERT
DRAPER, UT
NPI
1578852174
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: UT 8380171-1204)
Enumeration Date
2011-04-04
Last Update Date
2016-02-04
Business Address
-- LANCE DUSTIN ROBERT DO
12473 S MINUTEMAN DR
DRAPER, UT 84020-7870
Phone number: 801-495-7900
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Mailing Address
-- LANCE DUSTIN ROBERT DO
PO BOX 27128
SALT LAKE CITY, UT 84127-0128
Phone number: 801-495-7900
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