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Individual

RUBI CAROLINA MAY BURGOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5965 S 900 E, SALT LAKE CITY, UT 84121-1720
(801) 263-7100
Mailing address
6856 S 700 E, MIDVALE, UT 84047-5772
(801) 743-6100

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
02/18/2011
Last updated
10/19/2018
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