Organization
AVENUES TO HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSANA KINIKINI MOUNGA C-FNP (PRESIDENT)
(801) 521-2220
Entity
Organization
Contact information
Practice address
223 W 700 S, SUITE D, SALT LAKE CITY, UT 84101-2718
(801) 521-2220
(801) 521-2221
Mailing address
223 W 700 S, SUITE D, SALT LAKE CITY, UT 84101-2718
(801) 521-2220
(801) 521-2221
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
20071866
UT
Other
Enumeration date
03/05/2008
Last updated
03/05/2008
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