CARISSA MORA-RODRIGUEZ

SALT LAKE CITY, UT
NPI1629504642
Entity TypeOrganization
Authorized ContactCARISSA MORA-RODRIGUEZ
Owner
801-556-8064
Organization Subpart ?No
Primary Taxonomy302F00000X Exclusive Provider Organization
Enumeration Date2017-05-11
Last Update Date2017-05-11
Business Address
CARISSA MORA-RODRIGUEZ
415 E WOODLAKE LN #152
SALT LAKE CITY, UT 84107-1990
Phone number: 801-556-8064
Mailing Address
CARISSA MORA-RODRIGUEZ
415 E WOODLAKE LN #152
SALT LAKE CITY, UT 84107-1990
Phone number: 801-556-8064
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