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1861192700
ANGELA MARIE PROVSTGAARD
SALT LAKE CITY, UT
NPI
1861192700
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2023-03-08
Last Update Date
2023-03-08
Business Address
ANGELA MARIE PROVSTGAARD
344 E 100 S
SALT LAKE CITY, UT 84111-1700
Phone number: 801-428-4257
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Mailing Address
ANGELA MARIE PROVSTGAARD
344 E 100 S
SALT LAKE CITY, UT 84111-1700
Phone number: 801-428-4257
Copy
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