Most Relevant Information
Provider Data
NPI Number: | 1003326422 |
Provider Name: | ZOIE LEEANN BLEAK |
Entity Type: | Individual |
Taxonomy Code: | 225500000X |
Specialty: | Specialist/Technologist |
License Number: |
Most Important Dates
Enumeration Date: | 10/11/2017 |
Last Updated: | 10/11/2017 |
Provider Practice Location
4444 S 700 E
SALT LAKE CITY
UT
841073075
Practice Location Phone/Fax
Phone: | 8012684887 |
Fax: |
Provider Mailing Location
4444 S 700 E
SALT LAKE CITY
UT
841073075
Provider Mailing Phone/Fax
Phone: | |
Fax: |