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1174247605
LA VAISIGANO
SALT LAKE CITY, UT
NPI
1174247605
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2022-09-28
Last Update Date
2022-09-28
Business Address
LA VAISIGANO
4460 S HIGHLAND DR
SALT LAKE CITY, UT 84124-3543
Phone number: 888-949-4864
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Mailing Address
LA VAISIGANO
4460 S HIGHLAND DR
SALT LAKE CITY, UT 84124-3543
Phone number: 888-949-4864
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