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Individual

MR. BENJAMIN N BOTCHWAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
APRN, FNP-BC

Contact information

Practice address
1640 W 500 S, SALT LAKE CITY, UT 84104-5202
(801) 886-0930
(801) 886-0956
Mailing address
1798 N STALLION LN, SALT LAKE CITY, UT 84116-1115
(801) 440-8233
(801) 886-0956

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
337207-4405
UT

Other

Enumeration date
01/02/2009
Last updated
12/18/2020
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