Individual
DR. JACEK M BREWCZYNSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
SALT LAKE CITY HEALTH CARE SYSTEM, 500 FOOTHILL DRIVE (116 OP), SALT LAKE CITY, UT 84148-0001
(801) 582-1565
Mailing address
2256 FOOTHILL DR, APT 114, SALT LAKE CITY, UT 84109
(248) 730-6462
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
10/15/2011
Last updated
10/15/2011
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