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1063506889
CHARLES KIP DEWEESE
SALT LAKE CITY, UT
NPI
1063506889
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: UT 206077-4405)
Enumeration Date
2006-10-03
Last Update Date
2021-10-20
Business Address
CHARLES KIP DEWEESE APRN
82 S 1100 E SUITE 204
SALT LAKE CITY, UT 84102-1686
Phone number: 801-350-4602
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Mailing Address
CHARLES KIP DEWEESE APRN
82 S 1100 E SUITE 204
SALT LAKE CITY, UT 84102-1686
Phone number: 801-350-4602
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