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Individual

AUTUMN ROSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3809 W 6200 S, TAYLORSVILLE, UT 84129-3725
(888) 949-4864
Mailing address
3725 W 4100 S STE 201, WEST VALLEY CITY, UT 84120-5411

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
F25-117539
UT

Other

Enumeration date
12/16/2024
Last updated
02/12/2025
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