Individual
BRYAN THURSTON FLETCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
900 ROUND VALLEY DR STE 100, PARK CITY, UT 84060-7552
(435) 655-6600
Mailing address
1336 E 370 N, HEBER CITY, UT 84032-1355
(435) 225-6124
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
13007069-1206
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/13/2022
Last updated
08/27/2022
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