Individual
RETA NICHOLE MANWILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DEM
Contact information
Practice address
270 COATSVILLE AVE, SALT LAKE CITY, UT 84115-1927
(801) 415-9888
(801) 521-0196
Mailing address
270 COATSVILLE AVE, SALT LAKE CITY, UT 84115-1927
(801) 415-9888
(801) 521-0196
Taxonomy
Speciality
Code
Description
License number
State
175M00000X
Lay Midwife
Primary
—
—
Other
Enumeration date
02/26/2010
Last updated
02/26/2010
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