SYRACUSE FAMILY & OCCUPATIONAL MEDICINE PLLC NPI 1639466352

NPI Information

SYRACUSE FAMILY & OCCUPATIONAL MEDICINE PLLC is a primary care clinic center in Syracuse, UT. SYRACUSE FAMILY & OCCUPATIONAL MEDICINE PLLC NPI is 1639466352. The provider is registered as an organization entity type.

The provider's business location address is:

1842 S 2000 W # 2
SYRACUSE, UT
ZIP 84075-626
Phone: (801) 774-7450
Fax: (801) 774-7452

The provider's authorized official is Donald R Hastie .
The authorized official title is Owner / Operator and has the following contact phone number (801) 564-7091.

The enumeration date for this NPI number is 7/1/2011 and was last updated on 7/1/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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