Individual
GENESIS ROQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5371 W 4100 S, WEST VALLEY, UT 84120-4727
(801) 688-0396
Mailing address
5371 W 4100 S, WEST VALLEY, UT 84120-4727
(801) 688-0396
Taxonomy
Speciality
Code
Description
License number
State
171R00000X
Interpreter
Primary
—
—
Other
Enumeration date
01/07/2015
Last updated
01/07/2015
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