Individual
TANNER BOWEN HEATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0001
(801) 581-2121
Mailing address
1051 E 5950 S, SOUTH OGDEN, UT 84405-4892
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/18/2023
Last updated
01/18/2023
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