Provider Demographics
NPI:1568980688
Name:SNOW CANYON WOMENS CENTER PLLC
Entity Type:Organization
Organization Name:SNOW CANYON WOMENS CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:F
Authorized Official - Last Name:LYNN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:435-218-7770
Mailing Address - Street 1:965 E 700 S STE 105
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-4084
Mailing Address - Country:US
Mailing Address - Phone:435-218-7770
Mailing Address - Fax:
Practice Address - Street 1:965 E 700 S STE 105
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-4084
Practice Address - Country:US
Practice Address - Phone:435-218-7770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-08
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty