Individual
HIMASA J. WIJETUNGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
85 N MEDICAL DR, SALT LAKE CITY, UT 84112-1100
(801) 581-7985
Mailing address
85 N MEDICAL DR, SALT LAKE CITY, UT 84112-1100
(801) 581-7985
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
14168072-1205
UT
Other
Enumeration date
03/27/2023
Last updated
09/27/2024
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