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Individual

DAVID LIONEL PURBAUGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
11075 S STATE ST BLDG 32, SANDY, UT 84070-5164
(801) 432-7696
Mailing address
11075 S STATE ST BLDG 32, SANDY, UT 84070-5164

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
11788176-3502
UT

Other

Enumeration date
08/10/2020
Last updated
08/10/2020
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