Individual
KEANON COUSHAWN BATTLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2020 S 1300 E STE C, SALT LAKE CITY, UT 84105-3664
(801) 401-3515
Mailing address
1623 N 3860 W, LEHI, UT 84043-4652
(206) 751-8091
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
UT014160101108
UT
Other
Enumeration date
09/24/2024
Last updated
09/24/2024
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