Patrick Read Vanwagoner CRNA

NPI 1275745309 - Nurse Anesthetist, Certified Registered - 367500000X

NPI Details
NPI 1275745309
Gender Male
Enumeration Date 05/03/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
1067 N 500 W
PROVO UT, 84604, US
Phone (801) 375-8049
Fax (801) 374-9195
Business Location
PO BOX 1727
PROVO UT, 84603-1727, US
Phone (801) 375-8049
Fax (801) 374-9195
Toxanomy
Taxonomy Code 367500000X
License State Utah
License Number 191104-4406
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According to our database, Patrick Read Vanwagoner CRNA NPI is 1275745309, taxonomy code is 367500000X and license number is 191104-4406, license state is located at Utah. Patrick Read Vanwagoner CRNA physically located at 1067 N 500 W, Provo UT, 84604. NPI Number Patrick Read Vanwagoner CRNA has the Individual type.

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1275745309 NPI number is provided on an as is basis without warranty of any kind. 1275745309 is maintained by the National Plan & Provider Enumeration System. The contents of Patrick Read Vanwagoner CRNA are for informational purposes only.