Individual
GEORGIA RUSSELLYN HARTLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICENSED ACUPUNCTURI
Contact information
Practice address
2245 MONROE BLVD APT 29, OGDEN, UT 84401-1743
(801) 540-3502
Mailing address
4287 HARRISON BLVD # 156, OGDEN, UT 84403-3101
(801) 540-3502
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
1690016-1201
UT
Other
Enumeration date
03/14/2018
Last updated
03/14/2018
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