Organization · Type 2 NPI
Lars Bergeson, Md, PC
Health Service Clinic/Center · Providence, UT
NPI number
1336335884
Active
Practice location
382 N 280 W
Providence, UT 84332-0609
Fax (435) 755-0922
Mailing address
PO Box 609, 382 N 280 W
Providence, UT 84332-0609
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Health Service Clinic/Center Primary | 261QH0100X | 170371-1205 (UT) |
Health Service Clinic/Center: Definition to come...
Other health service clinic/center providers in Providence
About NPI 1336335884
Lars Bergeson, Md, PC's National Provider Identifier is 1336335884, issued on Sep 19, 2007. The primary taxonomy on file is Health Service Clinic/Center (261QH0100X), and the practice location is in Providence, UT. The record was last updated on Feb 1, 2010.