Most Relevant Information
Provider Data
| NPI Number: | 1003464843 |
| Provider Name: | MARJORIE ANN SUPULVER |
| Entity Type: | Individual |
| Taxonomy Code: | 253Z00000X |
| Specialty: | In Home Supportive Care |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/26/2019 |
| Last Updated: | 08/26/2019 |
Provider Practice Location
634 S MAIN ST
ST GEORGE
UT
847703921
Practice Location Phone/Fax
| Phone: | 4352319901 |
| Fax: |
Provider Mailing Location
634 S MAIN ST
ST GEORGE
UT
847703921
Provider Mailing Phone/Fax
| Phone: | 4352319901 |
| Fax: |