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Dr Lorell Fawson Dpm

in Ogden, UT. Organization (NPI-2).

NPI number1760664668
StatusActive
Last updated in NPPESJun 16, 2008

Details

NPI
1760664668
Entity type
Organization (NPI-2)
Legal business name
Dr Lorell Fawson Dpm
Organization subpart
No
Enumeration date
Dec 3, 2007
Last updated
Jun 16, 2008

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
213ES0131X ––Yes

Practice location

3590 Harrison Blvd
Suite G1
Ogden, UT 84403-2060

Phone 801-627-2122 · Fax 801-627-2125

Mailing address

3590 Harrison Blvd Suite G-1
Ogden, UT 84403

Phone 801-627-2122 · Fax 801-627-2125

Authorized official

Kathy Kersker
Office Manager
8016272122

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