Individual
KELLIE MARIE HERGET
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7575 S 900 E, MIDVALE, UT 84047-2343
(801) 208-1031
Mailing address
4525 S 1200 E, SALT LAKE CITY, UT 84117-4154
(801) 792-1622
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
10/13/2010
Last updated
10/13/2010
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