Individual
BENNETT JOSEPH CHARGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1832 N 1120 W, PROVO, UT 84604-1179
(801) 495-4800
Mailing address
1877 S 200 E APT 11, SALT LAKE CITY, UT 84115-2158
(952) 239-2754
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
10834959-4101
UT
Other
Enumeration date
05/21/2018
Last updated
05/21/2018
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