Individual
HAYDEE LARRALDE BLANCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
5285 S 400 E, SUITE A, WASHINGTON TERRACE, UT 84405-7194
(801) 393-5355
(801) 394-4609
Mailing address
2240 ADAMS AVE, OGDEN, UT 84401-1511
(801) 393-5355
(801) 394-4609
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
7374163-1205
UT
Other
Enumeration date
05/13/2008
Last updated
11/30/2011
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