Individual
MARK MANESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3539 S BYDE A WYLE RD, WEST VALLEY, UT 84119-3902
(801) 550-3451
Mailing address
3539 S BYDE A WYLE RD, WEST VALLEY, UT 84119-3902
(801) 550-3451
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
06/14/2021
Last updated
06/14/2021
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