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General NPI Number Information
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NPI Number | 1366767147
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Entity Type | Individual
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Provider Name | KATHY STRETCH GARCIA MD
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Gender | Female
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Dates
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Enumeration Date | 04/05/2010
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Last Update Date | 06/26/2018
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Provider Practice Location Address
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Address Line | 3556 W 9800 S STE 101
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City | SOUTH JORDAN
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State | UT
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Zip | 84095
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Country | US
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Telephone | 801-567-9780
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Fax | 801-567-9826
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Provider Business Mailing Address
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Address Line | 3556 W 9800 S STE 101
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City | SOUTH JORDAN
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State | UT
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Zip | 84095-3221
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Country | US
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Telephone | 801-567-9780
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Fax | 801-567-9826
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 4824557-1205
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License Number State | UT
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