Individual
DR. MIRJAM RAVNENG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
575 E 4500 S, SALT LAKE CITY, UT 84107-2973
(801) 266-3939
Mailing address
1110 E 200 S APT 1, SALT LAKE CITY, UT 84102-2596
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
11027277-2401
UT
Other
Enumeration date
08/06/2019
Last updated
08/06/2019
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