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1487213062
RUSSELL BENITEZ THORNWALL
SLC, UT
NPI
1487213062
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2019-06-07
Last Update Date
2019-06-07
Business Address
RUSSELL BENITEZ THORNWALL
344 E 100 S
SLC, UT 84111-1700
Phone number: 801-322-3222
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Mailing Address
RUSSELL BENITEZ THORNWALL
344 E 100 S
SLC, UT 84111-1700
Phone number: 801-322-3222
Copy
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