Individual
JANDRELY LOPEZ MORALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7495 S STATE ST, MIDVALE, UT 84047-2013
(801) 213-9400
Mailing address
7495 S STATE ST, MIDVALE, UT 84047-2013
(801) 213-9400
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
13425543-1205
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/24/2020
Last updated
10/22/2023
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