Individual
TORI MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
550 W 700 S, SLC, UT 84101-2281
(801) 697-1991
(801) 696-1991
Mailing address
4460 S HIGHLAND DR, SALT LAKE CITY, UT 84124-3543
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
UT
Other
Enumeration date
05/22/2018
Last updated
05/22/2018
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