Individual
KATIE S MYRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
375 CHIPETA WAY, STE A, SALT LAKE CITY, UT 84108-1261
(801) 587-3411
Mailing address
375 S CHIPETA WAY STE A, SALT LAKE CITY, UT 84108-1261
(801) 587-3411
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
12441606-1205
UT
Other
Enumeration date
04/06/2020
Last updated
01/22/2024
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