Organization
HERON MEDICAL PLLC
Active
Other names
Amy de la Garza, MD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMY NOEL DE LA GARZA MD (OWNER)
(801) 910-6189
Entity
Organization
Contact information
Practice address
77 S 700 E STE 220, SALT LAKE CITY, UT 84102-1162
(801) 910-6189
Mailing address
1941 E PRINCETON AVE, SALT LAKE CITY, UT 84108-1824
(801) 910-6189
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
10389489
UT
Other
Enumeration date
06/20/2017
Last updated
06/20/2017
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