Individual
CHARLES L HEAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
3838 S 700 E STE 300, SOUTH SALT LAKE, UT 84106-1496
(801) 261-4988
Mailing address
3838 S 700 E STE 300, SOUTH SALT LAKE, UT 84106-1496
(801) 261-4988
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
9266563-4405
UT
Other
Enumeration date
04/27/2023
Last updated
03/21/2024
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