Organization
YOUR HOME CLINIC COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA ANN NEWBY GNP (PRESIDENT)
(801) 641-9261
Entity
Organization
Contact information
Practice address
1032 LEARNED AVE, SALT LAKE CITY, UT 84116-3302
(801) 641-9261
(801) 521-4496
Mailing address
1032 LEARNED AVE, SALT LAKE CITY, UT 84116-3302
(801) 641-9261
(801) 521-4496
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
308579-4405
UT
Other
Enumeration date
01/25/2011
Last updated
01/25/2011
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