Individual
TYLER ASHTON BRIDGEWATER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
401 S 400 E, BOUNTIFUL, UT 84010-4933
(801) 295-2361
Mailing address
976 FOXBORO DR, NORTH SALT LAKE, UT 84054-6002
(801) 244-8968
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
7078841-4405
UT
Other
Enumeration date
07/17/2013
Last updated
07/17/2013
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