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Individual

DANIELLE CHASE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
659 N 700 E, APT 14, PROVO, UT 84606-6921
(208) 631-7498
Mailing address
659 N 700 E, APT 14, PROVO, UT 84606-6921
(208) 631-7498

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Enumeration date
09/08/2015
Last updated
09/08/2015
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