Individual
KEITH BEVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
TRS, CTRS
Contact information
Practice address
5965 S 900 E, SALT LAKE CITY, UT 84121-1720
(801) 263-7100
Mailing address
5965 S 900 E, SALT LAKE CITY, UT 84121-1720
(801) 263-7100
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
106526-4002
UT
Other
Enumeration date
03/09/2011
Last updated
03/09/2011
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