Most Relevant Information
Provider Data
| NPI Number: | 1003531468 |
| Provider Name: | GRACIE GILLMAN |
| Entity Type: | Individual |
| Taxonomy Code: | 172V00000X |
| Specialty: | Community Health Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/07/2022 |
| Last Updated: | 10/07/2022 |
Provider Practice Location
1970 W 7800 S
WEST JORDAN
UT
840884025
Practice Location Phone/Fax
| Phone: | 8012684887 |
| Fax: |
Provider Mailing Location
1970 W 7800 S
WEST JORDAN
UT
840884025
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |