Individual
BRANDON HENTKOWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
590 S WAKARA WAY, SALT LAKE CITY, UT 84108-1200
(801) 587-7198
Mailing address
590 S WAKARA WAY, SALT LAKE CITY, UT 84108-1200
(801) 587-7198
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000010234
MI
Other
Enumeration date
01/20/2015
Last updated
01/20/2015
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