Individual
BRIAN J PONTIUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MPAS PA-C
Contact information
Practice address
4095 E PONY EXPRESS PKWY, EAGLE MOUNTAIN, UT 84005-5529
(801) 429-8037
Mailing address
1055 N 500 W, ATT: CREDENTIALING, PROVO, UT 84604
(801) 354-8225
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5228191-1206
UT
Other
Enumeration date
09/05/2017
Last updated
11/27/2023
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