Individual
ADDISON UDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10894 S RIVER FRONT PKWY, SOUTH JORDAN, UT 84095-5609
(801) 878-1200
Mailing address
1801 WEDEMEYER ST UNIT 412, SAN FRANCISCO, CA 94129-5279
(480) 772-5353
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/17/2023
Last updated
04/17/2023
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