Individual
MR. WESTON MICHAEL KOFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NBC-HIS
Contact information
Practice address
38 WEST CENTER STREET GUNNISON, UT 84634, GUNNISON, UT 84634-7710
(888) 230-0875
Mailing address
8941 S 700 E STE 204, SANDY, UT 84070-2402
(732) 688-6486
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
9674125-4601
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
96374125-4601
STATE HEARING AID DISPENSER LICENSE
UT
Enumeration date
02/28/2019
Last updated
02/28/2019
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