Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 9284594-1204 | UT |
N | 207Q00000X | Family Doctor | DO177210 | OR |
Y | 207QS0010X | Family Doctor - Sports Medicine | 9284594-1204 | UT |
NPI | 1063675098 |
---|---|
Provider Name | Chase Austin Grames |
First Address | Salt Lake City, UT 84127-0128 |
Second Address | St George, UT 84790-7077 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2008 |
Last Update Date | 01/10/2021 |