Graduated: 1972
Offers telehealth
NPI: 1427128461
Practice Locations (2)
5635 S WATERBURY WAY, SUITE C202
SALT LAKE CITY, UT 841216210
5635 S WATERBURY WAY C, SUITE 202
SALT LAKE CITY, UT 841216210
8012780200
Source: CMS National Downloadable File, September 2026.