Individual
BRENT L GRIFFIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1034 N 500 W, PROVO, UT 84604-3380
(801) 357-4542
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 357-4542
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
1619961205
UT
Other
Enumeration date
07/20/2006
Last updated
08/12/2021
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