Individual
MS. BRYN PETRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5900 S BRENTWOOD DR, HOLLADAY, UT 84121-1506
(801) 688-3476
Mailing address
5900 S BRENTWOOD DR, HOLLADAY, UT 84121-1506
(801) 688-3476
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0613324976
—
UT
Enumeration date
03/12/2024
Last updated
03/12/2024
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