| Corner Canyon Pain & Medicine | |
|
12176 S 1000 E Ste 10 Draper UT 84020-3221 | |
| (801) 553-9691 | |
| (801) 571-4288 |
| Full Name | Corner Canyon Pain & Medicine |
|---|---|
| Speciality | General Practice |
| Location | 12176 S 1000 E Ste 10, Draper, Utah |
| Authorized Official Name and Position | Carl Gordon Lesueur (OWNER) |
| Authorized Official Contact | 8015539691 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Corner Canyon Pain & Medicine 12176 S 1000 E Ste 10 Draper UT 84020-3221 Ph: (801) 553-9691 | Corner Canyon Pain & Medicine 12176 S 1000 E Ste 10 Draper UT 84020-3221 Ph: (801) 553-9691 |
| NPI Number | 1992347512 |
|---|---|
| Provider Enumeration Date | 10/15/2019 |
| Last Update Date | 10/15/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992347512 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
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