Individual
AMBRI CORLETT CUNNINGHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
762 E 800 N, GENOLA, UT 84655-5056
(801) 995-0422
Mailing address
762 E 800 N, GENOLA, UT 84655-5056
(801) 995-0422
Taxonomy
Speciality
Code
Description
License number
State
405300000X
Prevention Professional
Primary
BOC268718
UT
Other
Enumeration date
04/17/2017
Last updated
04/17/2017
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