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1982933750
LARS BERGESON, M.D., PC
PROVIDENCE, UT
NPI
1982933750
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Entity Type
Organization
Authorized Contact
LARS BERGESON
Owner
435-752-0330
Organization Subpart ?
No
Primary Taxonomy
305S00000X Point of Service
Enumeration Date
2009-12-08
Last Update Date
2009-12-08
Business Address
LARS BERGESON, M.D., PC
382 W 280 N
PROVIDENCE, UT 84332-0609
Phone number: 435-752-0330
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Mailing Address
LARS BERGESON, M.D., PC
PO BOX 609 382 W 280 N
PROVIDENCE, UT 84332-0609
Phone number: 435-752-0330
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