Individual
RICHARD B VILLATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
519 S ELIZABETH ST STE 1, SALT LAKE CITY, UT 84102-3810
(801) 419-3893
Mailing address
519 S ELIZABETH ST STE 1, SALT LAKE CITY, UT 84102-3810
(801) 419-3893
Taxonomy
Speciality
Code
Description
License number
State
2083A0100X
Aerospace Medicine Physician
353333-1205
UT
2083X0100X
Occupational Medicine Physician
Primary
353333-1205
UT
Other
Enumeration date
03/21/2006
Last updated
06/21/2021
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