Individual
MAURIE MOLINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
825 E 1700 S, SALT LAKE CITY, UT 84105-3225
(972) 655-8714
Mailing address
825 E 1700 S, SALT LAKE CITY, UT 84105-3225
(972) 655-8714
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
UT
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
10/08/2018
Last updated
10/08/2018
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