Individual
ROSE BASILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
27 S MARIO CAPECCHI DR, SALT LAKE CITY, UT 84112-5888
(310) 433-8580
Mailing address
27 S MARIO CAPECCHI DR, SALT LAKE CITY, UT 84112-5888
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
00000000000000
UT
Other
Enumeration date
08/04/2025
Last updated
08/04/2025
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