Individual
MAR LYN LYN BOAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
817 W 950 S, BRIGHAM CITY, UT 84302-3071
(435) 695-2077
Mailing address
817 W 950 S, BRIGHAM CITY, UT 84302-3071
(435) 695-2077
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
372162-3102
UT
Other
Enumeration date
05/08/2019
Last updated
05/08/2019
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