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Individual

CORLISS REYNOLDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
215 S STATE ST, SUITE 110, SALT LAKE CITY, UT 84111-2319
(801) 441-1002
Mailing address
3072 W SWEET BLOSSOM DR, SOUTH JORDAN, UT 84095-3208

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4775745-4405
UT

Other

Enumeration date
12/02/2014
Last updated
12/02/2014
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