Individual
ZACHARY G WILLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
590 E 100 N, PRICE, UT 84501-2640
(435) 613-1500
Mailing address
590 E 100 N, PRICE, UT 84501-2640
(435) 613-1500
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
7815899-4810
UT
Other
Enumeration date
09/24/2018
Last updated
09/24/2018
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