Individual
JOSE LUIS SANDOVAL DE LEON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
260 S 1850 E RM 208, SALT LAKE CITY, UT 84112-0910
(801) 585-1820
Mailing address
260 S 1850 E RM 208, SALT LAKE CITY, UT 84112-0910
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
07/08/2020
Last updated
07/08/2020
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