Basic Information
Provider Information
NPI: 1679765861
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MORROW
FirstName: TONYA
MiddleName: LYNN
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 474 W 200 N
Address2: SUITE 300
City: ST GEORGE
State: UT
PostalCode: 847704505
CountryCode: US
TelephoneNumber: 4356345600
FaxNumber: 4359868700
Practice Location
Address1: 960 N DIXIE DOWNS RD
Address2:  
City: ST GEORGE
State: UT
PostalCode: 847704206
CountryCode: US
TelephoneNumber: 4356280612
FaxNumber: 4356288911
Other Information
ProviderEnumerationDate: 08/13/2007
LastUpdateDate: 08/13/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
247200000X  Y Technologists, Technicians & Other Technical Service ProvidersTechnician, Other 

ID Information
IDTypeStateIssuerDescription
MORROT01UTSWCBH STAFF CODEOTHER


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