MEDICARE: UESA LEOTALU

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	172V00000X	Community Health Worker

General Provider Information

NPI Number	:	1497390363
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	UESA LEOTALU

Provider Business Mailing Address
First Line	:	3476 W 7625 S
Second Line	:
City	:	WEST JORDAN
State	:	UT
Zip	:	84084-4510
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8783 S 2240 W
Second Line	:
City	:	WEST JORDAN
State	:	UT
Zip	:	84088-9363
Country	:	US
Telephone Number	:	801-432-7986
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2019
Last Update Date	:	11/14/2019

Similar Medicare Providers

1497832083 — DR. LYSA CHARLES MD
Practice Location Address:

2101 E JEFFERSON ST PPQA MEDICARE COMPLIANCE UNT 6 WEST , KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP
ROCKVILLE, MD
20852-4908

Practice Phone: 301-816-6660
Practice Fax: 301-816-6308

1295046100 — UTAH FAMILY MULTI CARE SERVICES, LLC
Practice Location Address:

8783 S 2240 W
WEST JORDAN, UT
84088-9363

Practice Phone: 801-432-7986
Practice Fax: 801-432-7663

1801431770 — ATHENA MAUGA
Practice Location Address:

8783 S 2240 W
WEST JORDAN, UT
84088-9363

Practice Phone: 801-432-7986
Practice Fax:

1730725243 — ROBERT VILLEGAS
Practice Location Address:

8783 S 2240 W
WEST JORDAN, UT
84088-9363

Practice Phone: 801-432-7986
Practice Fax:

1720113004 — WONEWOC AREA FIRE AND AMBULANCE ASSOCIATION, INC.
Practice Location Address:

200 WEST ST
WONEWOC, WI
53968-9363

Practice Phone: 608-464-3947
Practice Fax:

1407828122 — MRS. NICOLE LEIGH FRY P.T.
Practice Location Address:

9363 ALLEN RD
WEST CHESTER, OH
45069-3846

Practice Phone: 513-870-0039
Practice Fax: 513-870-0452

Directions to “ UESA LEOTALU ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.