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General NPI Number Information
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NPI Number | 1295087062
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Entity Type | Individual
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Provider Name | MISS MORGAN FAN DAY
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Gender | Female
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Dates
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Enumeration Date | 10/03/2012
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Last Update Date | 10/03/2012
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Provider Practice Location Address
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Address Line | 344 E 100 S STE 301
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City | SLC
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State | UT
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Zip | 84111-1727
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Country | US
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Telephone | 801-322-2457
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Fax |
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Provider Business Mailing Address
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Address Line | 11617 S COPPER ROSE WAY
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City | SOUTH JORDAN
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State | UT
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Zip | 84095-8189
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Country | US
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Telephone | 801-870-7000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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