Most Relevant Information
Provider Data
| NPI Number: | 1003520453 |
| Provider Name: | KACI BOBO |
| Entity Type: | Individual |
| Taxonomy Code: | 172V00000X |
| Specialty: | Community Health Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/10/2023 |
| Last Updated: | 01/10/2023 |
Provider Practice Location
780 S GUARDSMAN WAY
SALT LAKE CITY
UT
841081374
Practice Location Phone/Fax
| Phone: | 8889494864 |
| Fax: |
Provider Mailing Location
4460 S HIGHLAND DR
SALT LAKE CITY
UT
841243543
Provider Mailing Phone/Fax
| Phone: | 8889494864 |
| Fax: |