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Individual

PHILLIP SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
230 W 400 S, SALT LAKE CITY, UT 84101-1829
(801) 359-8862
Mailing address
230 W 400 S, SALT LAKE CITY, UT 84101-1829

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary

Other

Enumeration date
10/29/2020
Last updated
10/29/2020
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