SHANE MOZINGO

NORTH LOGAN, UT
NPI1295347474
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: UT  10646550-3102)
Enumeration Date2020-08-19
Last Update Date2020-12-14
Business Address
SHANE MOZINGO
2841 N 920 E
NORTH LOGAN, UT 84341-5806
Phone number: 435-512-1066
Mailing Address
SHANE MOZINGO
2841 N 920 E
NORTH LOGAN, UT 84341-5806
Phone number: 435-512-1066
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