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1295748705
DIANE S FEDORCHAK
SALT LAKE CITY, UT
NPI
1295748705
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
367A00000X Advanced Practice Midwife
(Licence: UT 2012884402)
Enumeration Date
2006-08-14
Last Update Date
2007-07-08
Business Address
-- DIANE S FEDORCHAK CNM
324 10TH AVE STE 163
SALT LAKE CITY, UT 84103-2856
Phone number: 801-408-1440
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Mailing Address
-- DIANE S FEDORCHAK CNM
PO BOX 27128
SALT LAKE CITY, UT 84127-0128
Phone number: 801-408-1440
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