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Individual

LOUIS WILLIAM DURANTE IV

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
368 E RIVERSIDE DR STE A, ST GEORGE, UT 84790-6897
(435) 673-1149
Mailing address
1187 E 3900 S, SALT LAKE CITY, UT 84124-1201
(801) 944-3199
(801) 944-3180

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
11/29/2022
Last updated
10/19/2023
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