Individual
ANDY ZANE DEINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
716 E 4500 S STE N160, MURRAY, UT 84107-3617
(801) 281-1100
Mailing address
PO BOX 520009, SALT LAKE CITY, UT 84152-0009
(801) 281-1100
(801) 281-1936
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
164834462
DRIVERS LICENSE
UT
Enumeration date
10/03/2018
Last updated
10/03/2018
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