Individual
MARK PUETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
21360 NORTH 1450 EAST, MORONI, UT 84646-0461
(435) 445-5200
(435) 445-5201
Mailing address
PO BOX 461, MORONI, UT 84646-0461
(435) 445-5200
(435) 445-5201
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
272503815
—
UT
Enumeration date
03/21/2014
Last updated
03/21/2014
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