Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath |
NPI | 1043789712 |
---|---|
Provider Name | Gregory Rich |
First Address | Sandy, UT 84092-5605 |
Second Address | Sandy, UT 84092-5605 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/11/2018 |
Last Update Date | 24/11/2018 |