Individual
EMILY KAY DETTENMAIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
850 E 9400 S STE 101, SANDY, UT 84094-4114
(385) 449-0565
Mailing address
1512 N 1285 W, OREM, UT 84057-6536
(801) 669-4467
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
322496-4405
UT
Other
Enumeration date
03/17/2020
Last updated
03/17/2020
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