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Individual

VICTOR VENEGAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
6065 S FASHION BLVD STE 255, MURRAY, UT 84107-5403
(801) 467-4210
Mailing address
965 E 900 N, BOUNTIFUL, UT 84010-2736
(801) 831-8561

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
7689207-4405
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00000
DONT CURRENTLY HAVE
UT
Enumeration date
03/24/2021
Last updated
10/12/2021
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