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NPI 1649804964

NPI 1649804964 : MARCI SORRELS : SANDY, UT

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General NPI Number Information
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    NPI Number           |    1649804964
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    Entity Type          |    Individual 
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    Provider Name        |    MARCI SORRELS
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/25/2020
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    Last Update Date     |    02/25/2020
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Provider Practice Location Address
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    Address Line         |    329 E 8680 S 
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    City                 |    SANDY
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    State                |    UT
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    Zip                  |    84070-1645
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    Country              |    US
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    Telephone            |    801-808-0153
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    329 E 8680 S 
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    City                 |    SANDY
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    State                |    UT
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    Zip                  |    84070-1645
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    Country              |    US
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    Telephone            |    801-808-0153
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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        |    3747A0650X
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    Taxonomy Name        |    Attendant Care Provider
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    License Number       |    
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    License Number State |    
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