Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 323274-1205 | UT |
NPI | 1063435832 |
---|---|
Provider Name | Shari J Welch |
First Address | Salt Lake City, UT 84157-1117 |
Second Address | Salt Lake City, UT 84103 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 21/01/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A16645 | (02) | UT |