Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | 12433563-4405 | UT |
NPI | 1033887195 |
---|---|
Provider Name | Michael S Orton |
First Address | Murray, UT 84123-5632 |
Second Address | Murray, UT 84123-5632 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2021 |
Last Update Date | 02/09/2021 |