Individual
CHRISTIAN DAVID FRIEDRICH AGRICOLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
30 N 1900 E, DEPARTMENT OF PSYCHIATRY, SALT LAKE CITY, UT 84132-0002
(801) 581-7951
Mailing address
562 N 400 W, SALT LAKE CITY, UT 84103-1310
(801) 574-8401
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
6348818-1205
UT
2084P0800X
Psychiatry Physician
Primary
6348818-8905
UT
Other
Enumeration date
02/26/2007
Last updated
11/17/2010
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