Provider Demographics
NPI:1124328349
Name:IRONS, LANCE
Entity type:Individual
Prefix:
First Name:LANCE
Middle Name:
Last Name:IRONS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21360 NORTH 1450 EAST
Mailing Address - Street 2:
Mailing Address - City:MORONI
Mailing Address - State:UT
Mailing Address - Zip Code:84646-0383
Mailing Address - Country:US
Mailing Address - Phone:435-851-6821
Mailing Address - Fax:
Practice Address - Street 1:21360 N 1450 E
Practice Address - Street 2:
Practice Address - City:MORONI
Practice Address - State:UT
Practice Address - Zip Code:84646-0383
Practice Address - Country:US
Practice Address - Phone:435-445-5200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-22
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)