| NPI | 1871030742 |
|---|---|
| Doing Business As | PROVIDER SURGICAL SERVICES |
| Entity Type | Organization |
| Authorized Contact | DANIEL R COTTAM Owner 801-523-0305 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Enumeration Date | 2017-01-30 |
| Last Update Date | 2022-01-10 |