Carissa Mora-Rodriguez
Carissa Mora-Rodriguez is an Exclusive Provider Organization in Salt Lake City, Utah. Registered with an NPI since 2017.
- In the registry since
- 2017
Practice location Address checks out
415 E Woodlake Ln #152Salt Lake City, UT 84107-1990
Phone: (801) 556-8064
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Exclusive Provider Organization (primary) | Taxonomy 302F00000X |
|---|
Record details
| NPI number | 1629504642 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Carissa Mora-Rodriguez — Owner · (801) 556-8064 |
| NPI enumerated | May 11, 2017 |
| Last updated in NPPES | May 11, 2017 |
| Mailing address | 415 E Woodlake Ln, 152, Salt Lake City, UT 84107-1990 |
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