Individual
POONAM PATHAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
58 COLONIAL AVE, LAYTON, UT 84041-3823
(801) 688-3926
Mailing address
58 COLONIAL AVE, LAYTON, UT 84041-3823
(801) 688-3926
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/10/2022
Last updated
05/10/2022
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