Individual
BRANDON SHANE PRINCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2853 S 3200 W, WEST VALLEY CITY, UT 84119-1723
(423) 458-2588
Mailing address
2853 S 3200 W, WEST VALLEY CITY, UT 84119-1723
(423) 458-2588
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
10129011-4701
UT
Other
Enumeration date
04/05/2017
Last updated
04/05/2017
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