Wise Cleft Center for Excellence LLC

NPI #1588407142 in Draper, Utah

Provider Information

NPI Number: 1588407142
Entity Type: Organization
Organization Name: Wise Cleft Center for Excellence LLC
Primary Specialty: Plastic Surgery
Enumeration Date: Jun 13, 2024
Last Updated: Feb 20, 2025

Practice Location

Address: 11762 S STATE ST STE 110
City: Draper
State: Utah
ZIP Code: 84020-7158
Phone: (385) 977-8125

Authorized Official

Name: GAVIN LAWRENCE
Title: DIRECTOR OF DEVELOPMENT
Phone: (435) 669-7660

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Plastic Surgery	208200000X	Primary

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