Individual
DR. BRIAN DION PETROVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
1186 E 4600 S, OGDEN, UT 84403-4332
(801) 505-6545
Mailing address
1186 E 4600 S, OGDEN, UT 84403-4332
(801) 505-6545
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2004017583
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
494703309
—
MO
Enumeration date
01/27/2006
Last updated
05/16/2022
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