Individual
ELLIOTT PHARES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2940 N CHURCH ST STE 204, LAYTON, UT 84040-6616
(801) 935-4171
Mailing address
2940 N CHURCH ST STE 204, LAYTON, UT 84040-6616
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/26/2020
Last updated
10/26/2020
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