Individual
MISTY KAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
576 E HIGHWAY 138 STE 400, STANSBURY PARK, UT 84074-4028
(435) 843-3647
Mailing address
107 W 2100 N, TOOELE, UT 84074-8198
(435) 228-8059
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
8395392-4901
UT
Other
Enumeration date
03/02/2015
Last updated
03/02/2015
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