NPI 1588407142
Wise Cleft Center for Excellence LLC
Practice location
- Address
- 11762 S State St STE 110, Draper, UT 84020-7158
- Phone
- (385) 977-8125
Authorised official
- Name
- Gavin Lawrence
- Title
- Director of Development
- Phone
- (435) 669-7660
Registered specialties
Plastic Surgery Physician
Primary
Registry record
- NPI
- 1588407142
- Entity type
- Organization
- NPI issued
- 13 Jun 2024
- Record last updated
- 20 Feb 2025
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.