Individual
DERREIN SHARRON WYNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4376 S 700 E, MILLCREEK, UT 84107-3350
(385) 272-4292
Mailing address
4376 SOUTH 700 EAST, MILLCREEK, UT 84107
(385) 272-4292
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/17/2023
Last updated
02/17/2023
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