Individual
BRECKA BANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
724 E 2100 S, SALT LAKE CITY, UT 84106-2335
(801) 487-0499
Mailing address
903 E AVILA DR, SANDY, UT 84094-5956
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/30/2024
Last updated
08/30/2024
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