Most Relevant Information
Provider Data
| NPI Number: | 1003528340 |
| Provider Name: | FAITH DANIELLE VON DWINGELO |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 12/19/2022 |
| Last Updated: | 12/19/2022 |
Provider Practice Location
1561 W 7000 S STE 200
WEST JORDAN
UT
840843556
Practice Location Phone/Fax
| Phone: | 8019904300 |
| Fax: | 8019672127 |
Provider Mailing Location
PO BOX 330
MAGNA
UT
840440330
Provider Mailing Phone/Fax
| Phone: | 8019904300 |
| Fax: | 8019672127 |