Daniel Edmund Banellis
NPI #1194087015 in Salt Lake City, Utah
Provider Information
- NPI Number
- 1194087015
- Entity Type
- Individual
- Name
- Daniel Edmund Banellis
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Substance Abuse Rehabilitation Facility
- Enumeration Date
- Jun 15, 2012
- Last Updated
- Jun 15, 2012
Practice Location
- Address
- 411 GRANT ST
- City
- Salt Lake City
- State
- Utah
- ZIP Code
- 84116-2725
- Phone
- (801) 359-8862
Specialties & Taxonomy Codes
| Specialty |
|---|
| Substance Abuse Rehabilitation Facility |
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