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Individual

DR. TASHA NICOLE ELLCHUK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BSC, MD, FRCPC

Contact information

Practice address
DEPARTMENT OF RADIOLOGY 30 NORTH 1900 E, SLC, UT 84132-0001
(801) 581-4626
Mailing address
DEPARTMENT OF RADIOLOGY 30 NORTH 1900 E, SLC, UT 84132-0001
(801) 581-4626

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
7057751-1205
UT

Other

Enumeration date
11/11/2008
Last updated
11/11/2008
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