Individual
LESLY ANAHI RICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
344 E 100 S, 301, SALT LAKE CITY, UT 84111-1700
(801) 322-4257
Mailing address
1510 W ARAPAHOE AVE, SALT LAKE CITY, UT 84104-2600
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
175566878
UT
Other
Enumeration date
05/20/2013
Last updated
05/20/2013
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