MADELINE BANTA

SALT LAKE CITY, UT
NPI1649717562
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy133VN1004X Dietitian, Registered, Nutrition, Pediatric
Enumeration Date2017-01-30
Last Update Date2022-02-02
Business Address
MADELINE BANTA RD, LD
100 N MARIO CAPECCHI DR
SALT LAKE CITY, UT 84113-1103
Phone number: 801-662-5329
Mailing Address
MADELINE BANTA RD, LD
865 S AMANDA AVE
SALT LAKE CITY, UT 84105-1625
Phone number: 801-755-8056
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