Individual
BRISA K AYUB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
447 BEARCAT DR, SALT LAKE CITY, UT 84115-2519
(801) 355-2846
Mailing address
1840 S 1300 E, SALT LAKE CITY, UT 84105-3617
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
02/08/2012
Last updated
02/08/2012
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