Most Relevant Information
Provider Data
| NPI Number: | 1003468018 |
| Provider Name: | SIERRA MOOSMAN |
| Entity Type: | Individual |
| Taxonomy Code: | 172V00000X |
| Specialty: | Community Health Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/10/2019 |
| Last Updated: | 07/10/2019 |
Provider Practice Location
697 W 4170 S
MURRAY
UT
841231326
Practice Location Phone/Fax
| Phone: | 8012619177 |
| Fax: |
Provider Mailing Location
697 W 4170 S
MURRAY
UT
841231326
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |