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Individual

KENNETH BRIGHTON MARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CFA, SA-C

Contact information

Practice address
5901 SPRING CANYON RD, OGDEN, UT 84403-5477
(801) 513-3171
Mailing address
5901 SPRING CANYON RD, OGDEN, UT 84403-5477
(801) 991-0762

Taxonomy

Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
97014

Other

Enumeration date
02/26/2006
Last updated
08/09/2011
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