Individual
MRS. CAROLE A RAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDR
Contact information
Practice address
200 N 400 E, PANGUITCH, UT 84759-0389
(435) 676-8811
(435) 676-1541
Mailing address
200 N 400 E, PANGUITCH, UT 84759-0389
(435) 676-8811
(435) 676-1541
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
4825083-4901
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4825083-4901
LICENSE #
UT
Enumeration date
08/16/2007
Last updated
08/16/2007
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