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Individual

MRS. VINODHINI KOLANDAVELU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
30 N 1900 E, 50M 4R118, SALT LAKE CITY, UT 84132-0002
(801) 581-7803
Mailing address
1059 UNIVERSITY VLG, SALT LAKE CITY, UT 84108-3454
(678) 622-6179

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
8111395-1206
UT

Other

Enumeration date
11/28/2011
Last updated
12/20/2021
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