Individual
MR. BRYAN BERNELL HOFHEINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1055 N 500 W STE 102, PROVO, UT 84604-3305
(385) 203-1107
(801) 429-0629
Mailing address
703 STRAWBERRY RD, SALEM, UT 84653-5695
(435) 632-2845
(801) 429-0629
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
378238-1206
UT
363AM0700X
Medical Physician Assistant
Primary
378238-1206
UT
Other
Enumeration date
09/21/2006
Last updated
07/08/2015
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