Individual
BERNARD M MUTIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
12433 S FORT ST, DRAPER, UT 84020-9363
(801) 576-1086
(801) 576-9796
Mailing address
5505 S 900 E, HOLLADAY, UT 84117-7209
(801) 783-5011
(801) 746-3734
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
79878114405
UT
Other
Enumeration date
10/04/2017
Last updated
06/11/2020
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