Individual
MALLORY SPEAKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
500 FOOTHILL DR, SALT LAKE CITY, UT 84148-0001
(801) 582-1565
Mailing address
5754 CANAL ST, TOOELE, UT 84074-7415
(714) 475-8596
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
12841899-3102
UT
Other
Enumeration date
05/04/2022
Last updated
11/14/2024
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