Individual
BART DOUGLAS HENNAGIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ASSOCIATES OF SCIENC
Contact information
Practice address
21360 N 1450 E, MORONI, UT 84646-0461
(435) 445-5200
Mailing address
PO BOX 461, MORONI, UT 84646-0461
(435) 445-5200
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235458555
—
UT
Enumeration date
09/30/2014
Last updated
09/30/2014
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