Gustavo Carrillo

NPI #1114542255 in Salt Lake City, Utah

Provider Information

NPI Number
1114542255
Entity Type
Individual
Name
Gustavo Carrillo
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Physician Assistant
Enumeration Date
Jun 15, 2020
Last Updated
Dec 17, 2021

Practice Location

Address
610 S 200 E STE B
State
Utah
ZIP Code
84111-3802
Phone
(602) 626-4835

Specialties & Taxonomy Codes

Specialty
Physician Assistant

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