Individual
MS. RAIJA P. MADDOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP, APRN
Contact information
Practice address
415 EAST 3900 SOUTH, MALIHEH FREE CLINIC, SALT LAKE CITY, UT 84107
(801) 266-3700
(801) 266-3721
Mailing address
2553 BEVERLY ST, SALT LAKE CITY, UT 84106
(801) 485-5445
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
188101-4405
UT
Other
Enumeration date
12/17/2013
Last updated
12/17/2013
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