Individual
BRESHAE CHRISTOFFERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
630 E 1400 N STE 140, LOGAN, UT 84341-2549
(435) 213-3850
Mailing address
1795 CANYON RIDGE DR, NORTH LOGAN, UT 84341-8314
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
10195986-2402
UT
Other
Enumeration date
04/13/2018
Last updated
04/13/2018
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