Individual
TRACY LAVELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1020 S MAIN ST, SALT LAKE CITY, UT 84101-3176
(801) 273-6366
Mailing address
3725 W 4100 S STE 201, WEST VALLEY CITY, UT 84120-5427
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
13029077-3102
UT
Other
Enumeration date
04/24/2024
Last updated
04/24/2024
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