Individual
MICHAEL MIRACLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4793 S OLIVE AVE, MAPLETON, UT 84664-5096
(385) 427-8956
Mailing address
4793 S OLIVE AVE, MAPLETON, UT 84664-5096
(385) 427-8956
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
12082884-3102
UT
Other
Enumeration date
05/15/2026
Last updated
05/15/2026
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