Individual
LAUREL LYNNE FETZER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
4727 S RAINBOW DR, MURRAY, UT 84107-3811
(801) 414-9336
Mailing address
4727 S RAINBOW DR, MURRAY, UT 84107-3811
(801) 414-9336
Taxonomy
Speciality
Code
Description
License number
State
136A00000X
Registered Dietetic Technician
Primary
9266996-4901
UT
Other
Enumeration date
10/13/2016
Last updated
10/13/2016
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