Mountain Spine PC

NPI #1699209221 in Draper, Utah

Provider Information

NPI Number: 1699209221
Entity Type: Organization
Organization Name: Mountain Spine PC
Primary Specialty: Specialist
Enumeration Date: Apr 20, 2017
Last Updated: Apr 20, 2017

Practice Location

Address: 11613 S STATE ST
City: Draper
State: Utah
ZIP Code: 84020-9456
Phone: (385) 414-7080

Authorized Official

Name: GARY D SNOOK, MD
Title: MEDICAL DOCTOR/ OWNER
Phone: (385) 414-7080

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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