Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 1742241202 | UT |
NPI | 1427078666 |
---|---|
Provider Name | Dr. Gary Rosquist |
First Address | Murray, UT 84107-6515 |
Second Address | Murray, UT 84107-6515 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 08/07/2007 |