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Individual

MR. BENITO LEAL GARCIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
500 FOOTHILL BLVD, SALT LAKE CITY, UT 84148-0001
(801) 582-1565
Mailing address
487 STANLEY AVE, SALT LAKE CITY, UT 84115-4015
(801) 598-7567

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
219025-4405
UT

Other

Enumeration date
06/23/2008
Last updated
06/23/2008
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