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Individual

MR. EDWARD EUGENE WIRKOWSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
APRN

Contact information

Practice address
500 FOOTHILL DRIVE, BUILDING 3 - IPU, SALT LAKE CITY, UT 84148
(801) 582-1565
Mailing address
7345 S CLAIM JUMPER CIR, COTTONWOOD HEIGHTS, UT 84121-4601

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
6555
CT

Other

Enumeration date
05/26/2016
Last updated
05/17/2019
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