Provider Demographics
NPI:1073875993
Name:FRANCIS, LORETTA MARY (MASTER ESTHETICIAN)
Entity Type:Individual
Prefix:MRS
First Name:LORETTA
Middle Name:MARY
Last Name:FRANCIS
Suffix:
Gender:F
Credentials:MASTER ESTHETICIAN
Other - Prefix:
Other - First Name:LORETTA
Other - Middle Name:MARY
Other - Last Name:KING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3833 SAGE VISTA LN
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILLS
Mailing Address - State:UT
Mailing Address - Zip Code:84062-8571
Mailing Address - Country:US
Mailing Address - Phone:801-636-6166
Mailing Address - Fax:
Practice Address - Street 1:6095 S FASHION BLVD
Practice Address - Street 2:SUITE 270
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-7397
Practice Address - Country:US
Practice Address - Phone:801-213-8351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-15
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6777731-1109247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other