Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 6763546-4405 | UT |
NPI | 1093236895 |
---|---|
Provider Name | Chantel Leigh Duffey |
First Address | Sandy, UT 84094-3713 |
Second Address | Murray, UT 84107-6768 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2017 |
Last Update Date | 30/06/2017 |