Individual
STACEY BAGANZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCHN, MS
Contact information
Practice address
2499 LEDGER WAY, PARK CITY, UT 84060-1220
(858) 248-5343
Mailing address
2499 LEDGER WAY, PARK CITY, UT 84060-1220
(588) 248-5343
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
—
Other
Enumeration date
12/04/2015
Last updated
11/03/2023
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