Individual
SAMUEL MARQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CPSS
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
175T00000X
Peer Specialist
Primary
1581
UT
Other
Enumeration date
12/16/2021
Last updated
12/16/2021
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