Individual
ELIZABETH WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4401 HARRISON BLVD, OGDEN, UT 84403-3195
(801) 387-7539
Mailing address
4401 HARRISON BLVD, OGDEN, UT 84403-3195
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
07/28/2017
Last updated
03/17/2018
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