Shade, Antonio
Shade, Antonio is an sole proprietor health care provider with primary practice located at 344 E 100 S , Salt Lake City UT 84111-1700. He recently has only one registered license in Other Service Providers / Community Health Worker, which is considered as his primary health care specialty. Shade, Antonio can be contacted via phone (801) 428-4257.Contact Information
Primary practice address
344 E 100 S
Salt Lake City UT 84111-1700
Phone: (801) 428-4257
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Community Health Worker | 172V00000X | 13752698-3502 | Utah |
Profile Details
| NPI number | 1497518716 |
|---|---|
| LBN Legal business name | Shade, Antonio |
| Credentials | Certified Social Worker (CSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 31st, 2024 |
| Last updated | Jan 31st, 2024 - about 2 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.
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