NPI 1194087015
Daniel Edmund Banellis
Practice location
- Address
- 411 Grant St, Salt Lake City, UT 84116-2725
- Phone
- (801) 359-8862
- Fax
- (801) 359-8510
- Mailing address
- 400 North 1756 West, APT 56b, Salt Lake City, UT 84116
Registered specialties
Substance Abuse Rehabilitation Facility
Primary
Registry record
- NPI
- 1194087015
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 15 Jun 2012
- Record last updated
- 15 Jun 2012
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.