Individual
LORENA ALICIA VILLARREAL DE CANTU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
5285 S 400 E, WASHINGTON TERRACE, UT 84405-7194
(801) 393-5355
(801) 394-4609
Mailing address
2240 ADAMS AVE, OGDEN, UT 84401-1511
(801) 393-5355
(801) 394-4609
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8085892-1206
UT
Other
Enumeration date
11/21/2011
Last updated
11/21/2011
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