Individual
MISHA FOTOOHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
375 S CHIPETA WAY STE A, SALT LAKE CITY, UT 84108-1261
(801) 581-8250
Mailing address
375 S CHIPETA WAY STE A, SALT LAKE CITY, UT 84108-1261
(801) 581-8250
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
V
UT
Other
Enumeration date
04/04/2020
Last updated
09/15/2021
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