Individual
ELIZABETH WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1525 N 200 W, LOGAN, UT 84341-2032
(435) 752-8880
Mailing address
1525 N 200 W, LOGAN, UT 84341-2032
(435) 752-8880
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
—
Enumeration date
09/16/2022
Last updated
09/16/2022
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