Individual
BRENT WEBB
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Contact information
Practice address
1452 E RIDGELINE DR, #51, SOUTH OGDEN, UT 84405-4946
(801) 479-5777
(801) 479-7005
Mailing address
1466 FLINT CT, KAYSVILLE, UT 84037-9534
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
120650-2401
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107001618103
IHC ADVOCATES # PROVO
UT
01
—
5577514
DMBA PROV # PROVO
UT
01
—
577514
DMBA PROV # OGDEN
UT
01
—
TPRA10491
MOLINA PROV # PROVO
UT
Enumeration date
05/23/2006
Last updated
07/08/2007
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