Provider Information for 1417326877
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CAMILLE ANDERSON
Sex: Female
NPI: 1417326877
Last Updated: 2015-09-16
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1417326877 | ||||||||
| Enumeration Date | 2015-09-16 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 609 N 200 W HEBER, UT 84032 United States Phone: 435-671-3910 | Fax: | ||||||||
| Primary Practice Address | 609 N 200 W HEBER CITY, UT 84032-1447 United States Phone: 435-671-3910 | Fax: | ||||||||
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