Individual
TAMA ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
133 S 500 E, VERNAL, UT 84078-2728
(435) 247-1177
Mailing address
133 S 500 E, VERNAL, UT 84078-2728
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
48831153102
UT
Other
Enumeration date
03/11/2015
Last updated
03/11/2015
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