Individual
RICHARD BRAITHWAITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 FOOTHILL DR, SALT LAKE CITY, UT 84148-0001
(801) 582-1565
Mailing address
500 FOOTHILL DR, SALT LAKE CITY, UT 84148-0001
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
460
UT
Other
Enumeration date
01/06/2009
Last updated
01/06/2009
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