Individual
BLAINE LADD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
474 W 200 N, SAINT GEORGE, UT 84770-4505
(435) 634-5660
Mailing address
2496 CRESTVIEW DR, SANTA CLARA, UT 84765-5557
(435) 574-8670
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
05/03/2011
Last updated
05/03/2011
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