DANIEL EDMUND BANELLIS

SALT LAKE CITY, UT
NPI1194087015
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy324500000X Substance Abuse Rehabilitation Facility
Enumeration Date2012-06-15
Last Update Date2012-06-15
Business Address
-- DANIEL EDMUND BANELLIS
411 GRANT ST
SALT LAKE CITY, UT 84116-2725
Phone number: 801-359-8862
Mailing Address
-- DANIEL EDMUND BANELLIS
400 NORTH 1756 WEST, APT 56B
SALT LAKE CITY, UT 84116
Phone number: 801-359-8862
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