Individual
KEVIN GMITRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
344 E 100 S STE 301, SALT LAKE CITY, UT 84111-1727
(801) 322-4257
Mailing address
9608 S EASTDELL DR, SANDY, UT 84092-3361
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0
—
UT
Enumeration date
12/11/2013
Last updated
12/11/2013
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