Individual
MATTHEW RAY PICKUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN - CRNA
Contact information
Practice address
1050 E SOUTH TEMPLE, SALT LAKE CITY, UT 84102-1507
(801) 750-2888
Mailing address
311 E 1700 S, SALT LAKE CITY, UT 84115-1729
(801) 750-2888
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
8659807-8901
UT
Other
Enumeration date
01/11/2022
Last updated
01/11/2022
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