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Individual

MRS. CARRIE PUALANILEIMAKAMAE PEREYRA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
BRIGHAM YOUNG UNIVERSITY, 173 RICHARDS BUILDING, PROVO, UT 84602
(801) 422-1628
Mailing address
291 W 1150 N, SPRINGVILLE, UT 84663-4212
(808) 640-4955

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
UT

Other

Enumeration date
03/22/2018
Last updated
03/22/2018
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