Individual
WALT WHITEHEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
82 S 800 W, BRIGHAM CITY, UT 84302-2400
(435) 723-8548
Mailing address
82 S 800 W, BRIGHAM CITY, UT 84302-2400
(435) 723-8548
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/19/2014
Last updated
02/19/2014
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