Gully, Mary
Gully, Mary is an sole proprietor health care provider with primary practice located at 177 W Price Ave , Salt Lake City UT 84115-4345. She recently has only one registered license in Agencies / Case Management, which is considered as her primary health care specialty. Gully, Mary can be contacted via phone (385) 468-4548.Contact Information
Primary practice address
177 W Price Ave
Salt Lake City UT 84115-4345
Phone: (385) 468-4548
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Agencies / Case Management | 251B00000X |
Profile Details
| NPI number | 1235558180 |
|---|---|
| LBN Legal business name | Gully, Mary |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 8th, 2014 |
| Last updated | Apr 8th, 2014 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1235558180 | NPPES |
| Utah | MEDICAID | 876000316 |
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