Individual
DR. WIRT A HINES II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1121 E 3900 S, SUITE C-125, SALT LAKE CITY, UT 84124-1214
(801) 266-3400
(801) 266-3401
Mailing address
1121 E 3900 S, SUITE C-125, SALT LAKE CITY, UT 84124-1214
(801) 266-3400
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1505831205
UT
Other
Enumeration date
11/20/2006
Last updated
07/08/2007
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