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General NPI Number Information
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NPI Number | 1588038012
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Entity Type | Individual
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Provider Name | MONICA LEIGH DAVIES MOTR/L
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Gender | Female
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Dates
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Enumeration Date | 11/20/2015
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Last Update Date | 11/20/2015
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Provider Practice Location Address
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Address Line | 3419 W 12600 S
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City | RIVERTON
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State | UT
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Zip | 84065-7265
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Country | US
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Telephone | 801-693-3941
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Fax |
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Provider Business Mailing Address
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Address Line | 412 E CATTAIL CT
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City | SARATOGA SPRINGS
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State | UT
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Zip | 84045-8119
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Country | US
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Telephone | 801-414-9021
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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 | 9057920-4201
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License Number State | UT
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