Organization
VDCPT801 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIRGILIO ENRICO PELAEZ DEL CASTILLO (MEMBER)
(801) 671-5384
Entity
Organization
Contact information
Practice address
1003 W FREMONT AVE, SALT LAKE CITY, UT 84104-2007
(801) 671-5384
Mailing address
1003 W FREMONT AVE, SALT LAKE CITY, UT 84104-2007
(801) 671-5384
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
02/25/2020
Last updated
02/26/2020
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