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Individual

JUSTINE B. LY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
375 S CHIPETA WAY STE A, SALT LAKE CITY, UT 84108-1261
(801) 587-3411
Mailing address
375 S CHIPETA WAY STE A, SALT LAKE CITY, UT 84108-1261
(801) 587-3411

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
12984943-1205
UT

Other

Enumeration date
03/26/2021
Last updated
08/16/2022
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