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Individual

MR. GREG SPEZIALE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
36 RACQUET CLUB DR, PARK CITY, UT 84060
(801) 425-8767
Mailing address
2100 PARK AVE UNIT 682941, PARK CITY, UT 84068-4619
(801) 425-8767

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
1478
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1478
STATE OF UTAH CERTIFIED PEER SUPPORT SPECIALIST
UT
Enumeration date
02/23/2022
Last updated
02/23/2022
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