Organization Name: | CASTLE VALLEY FOOT & ANKLE PC |
NPI Number: | 1194956359 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BRIAN J GRIFFETH (PRESIDENT) |
Mailing Address: | 250 N Fairgrounds Rd Suite 3 Price |
State: | UT US |
Postal Code: | 845014203 |
Phone Number: | 4356376797 |
Fax Number: | |
NPI Enumeration Date: | 08/05/2009 |
NPI Last Update Date: | 03/02/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | 73654690501 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |