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1467191510
MIRA ALIENE BETTENDORF
SOUTH SALT LAKE, UT
NPI
1467191510
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: UT 10853434-4202)
Enumeration Date
2022-05-27
Last Update Date
2022-05-27
Business Address
Miss MIRA ALIENE BETTENDORF COTA/L
2500 S STATE ST
SOUTH SALT LAKE, UT 84115-3164
Phone number: 385-646-5000
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Mailing Address
Miss MIRA ALIENE BETTENDORF COTA/L
2500 S STATE ST
SOUTH SALT LAKE, UT 84115-3164
Phone number: 385-646-5000
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