Individual
CARRIE ANN BEZZANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
370 E WOODLAKE DR, APT 125, SALT LAKE CITY, UT 84107-1862
(801) 699-9926
Mailing address
370 E WOODLAKE DR, APT 125, SALT LAKE CITY, UT 84107-1862
(801) 699-9926
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
6922421-4810
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020802023
BOC
—
Enumeration date
11/12/2015
Last updated
11/12/2015
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