Individual
GASPAR RICO VALDEZ IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
804 E GENTILE ST, LAYTON, UT 84041-4330
(385) 439-8137
Mailing address
804 E GENTILE ST, LAYTON, UT 84041-4330
(385) 439-8137
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
179013623
—
UT
Enumeration date
05/26/2022
Last updated
05/26/2022
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