Courtney Taylor

Valley Medical Center 
31097 Benitez Points
Mariehaven, UT 63717
 Facility Phone #: 378-469-6815 
 patient name: Courtney Taylor 
 DATE OF BIRTH 1995-04-09 Age: 22 years 
 Sex M 
 MRN: 3841981753(SBM) 
 ADMITTING DATE: 2020-26-02 
 Acct #: 71064685012 
 Disch Date: 2020-27-03 
 Pt loc: SBMC 6TNS; 643;66 
 Physician: 
 Dr Thomas Moore DO 
 PCP: 
 PCP,Not on Staff 
 Operative and Procedure Reports 
 Electronically Signed By: 
 Dr Gary House MD 
 On 2023-18-03 1:57 
 Co Signature By: 
 Dr Debra Myers MD 
 On 2023-18-03 1:57 
 Modified Signature By: 
 Dr Gary House MD 
 On 2023-18-03 1:57 
 Date/Time Printed 2016-06-06 12:52 PST 
 Report Request ID: 233133513 
 Page 245 of 379 
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