Individual
GITA ENTEZAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1525 W 2100 S, SALT LAKE CITY, UT 84119-1401
(801) 213-9950
(801) 213-9965
Mailing address
5367 HILLSDEN DR, SALT LAKE CITY, UT 84117-7741
(801) 272-7263
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
152501-1701
UT
Other
Enumeration date
05/27/2006
Last updated
11/16/2015
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