Individual
CRYSTAL ROSE LENZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
ECCLESS INSTITUTE OF HUMAN GENETICS: 15 N MEDICAL DR RM, SPACE BASE DELTA 1, SALT LAKE CITY, UT 84112
(801) 581-2121
Mailing address
ECCLESS INSTITUTE OF HUMAN GENETICS: 15 N MEDICAL DR RM, SPACE BASE DELTA 1, SALT LAKE CITY, UT 84112
(801) 581-2121
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
13891982-1204
UT
2083A0100X
Aerospace Medicine Physician
DR0051668
CO
208D00000X
General Practice Physician
DR0051668
CO
208D00000X
General Practice Physician
OS11932
FL
Other
Enumeration date
04/08/2011
Last updated
03/29/2024
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