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1104671130
KENNEDY BUSTAMANTE
MIDVALE, UT
NPI
1104671130
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2024-04-22
Last Update Date
2024-04-22
Business Address
KENNEDY BUSTAMANTE
6856 S 700 E
MIDVALE, UT 84047-1361
Phone number: 801-743-6100
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Mailing Address
KENNEDY BUSTAMANTE
3725 W 4100 S STE 201
WEST VALLEY CITY, UT 84120-5427
Phone number: 888-949-4864
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