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1790396554
STEPHANIE G MISHENKO
SLC, UT
NPI
1790396554
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
171000000X Military Health Care Provider
Enumeration Date
2020-08-13
Last Update Date
2020-08-13
Business Address
STEPHANIE G MISHENKO
344E 100S
SLC, UT 84111
Phone number: 801-322-3222
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Mailing Address
STEPHANIE G MISHENKO
344E 100S
SLC, UT 84111
Phone number: 801-322-3222
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