Individual
ANTONIO GONZALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3269 S MAIN ST STE 230, SOUTH SALT LAKE, UT 84115-3769
(801) 935-4447
Mailing address
3269 S MAIN ST STE 230, SOUTH SALT LAKE, UT 84115-3769
(801) 935-4447
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
Primary
2027
UT
Other
Enumeration date
04/29/2020
Last updated
04/25/2023
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