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Individual

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Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ND

Contact information

Practice address
126 W 12300 S STE C, DRAPER, UT 84020-9801
(385) 237-3110
Mailing address
1994 W CARRIAGE AVE, RIVERTON, UT 84065-5748
(801) 708-9076

Taxonomy

Speciality
Code
Description
License number
State
175F00000X
Naturopath
Primary
100519-9932
UT

Other

Enumeration date
11/03/2020
Last updated
11/03/2020
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