Individual
CARLY ANNE CARDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
243 E 6100 S, SALT LAKE CITY, UT 84107-7302
(801) 581-2955
Mailing address
9612 S CARRIAGE CHASE LN, SANDY, UT 84092-6311
(801) 935-0437
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
12254702-1109
UT
Other
Enumeration date
05/27/2022
Last updated
05/27/2022
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