Healthcare Provider Details

I. General information

NPI: 1992768824
Provider Name (Legal Business Name): CHARLENE VOSSELLER CASE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2006
Last Update Date: 03/02/2023
Certification Date: 03/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1248 E 90 N STE 300
AMERICAN FORK UT
84003-2956
US

IV. Provider business mailing address

1738 W CHACO CIR
LEHI UT
84043-6939
US

V. Phone/Fax

Practice location:
  • Phone: 801-756-9635
  • Fax: 801-216-8357
Mailing address:
  • Phone: 413-262-8491
  • Fax: 801-216-8357

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number160056
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: