Individual
BRENT LEE THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTITIONER
Contact information
Practice address
441 S REDWOOD RD, SLC, UT 84104-3539
(801) 973-2588
(801) 973-6985
Mailing address
441 S REDWOOD RD, SLC, UT 84104-3539
(801) 973-2588
(801) 973-6985
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
8021622-8900
UT
Other
Enumeration date
06/23/2016
Last updated
06/23/2016
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