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1306391370
MIKALA FAIRBANKS
OREM, UT
NPI
1306391370
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
(Licence: UT 178234323)
Enumeration Date
2016-08-19
Last Update Date
2016-08-19
Business Address
-- MIKALA FAIRBANKS
638 N 450 W
OREM, UT 84057-3794
Phone number: 801-373-4760
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Mailing Address
-- MIKALA FAIRBANKS
638 N 450 W
OREM, UT 84057-3794
Phone number: 801-717-6027
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