NPI 1326274507

Logan Urology Clinic

Organisation Exclusive Provider Organization Logan, UT

Practice location

Address: 550 E 1400 N STE J, Logan, UT 84341-2406
Phone: (435) 753-1171
Fax: (435) 792-4464

Authorised official

Name: Ryan Harold Larsen
Title: Physician
Phone: (435) 753-1171

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence 175141-1205 (UT)

Other Exclusive Provider Organization providers in Utah →

Registry record

NPI: 1326274507
Entity type: Organization
NPI issued: 2 Jun 2009
Record last updated: 2 Jun 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.