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Individual

PAUL W BRINKERHOFF

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
C.P.

Contact information

Practice address
59 S MAIN ST, ROOSEVELT, UT 84066-3106
(435) 725-0999
Mailing address
59 S MAIN ST, ROOSEVELT, UT 84066-3106
(435) 725-0999

Taxonomy

Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
870536042008
UT
01
87053604202001
BXBS
UT
Enumeration date
10/01/2006
Last updated
11/06/2007
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