Individual
MELISSA SQUIRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
714 S STATE ST, OREM, UT 84058-6366
(801) 666-4792
Mailing address
47 N 870 E, AMERICAN FORK, UT 84003-2965
(801) 471-3488
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
10654460-3101
UT
Other
Enumeration date
03/12/2019
Last updated
03/12/2019
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