Individual
BRENT K THURGOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4650 HARRISON BLVD, OGDEN, UT 84403-4303
(801) 475-3200
(801) 475-3204
Mailing address
PO BOX 5546, DENVER, CO 80217-5546
(801) 475-3200
(801) 475-3204
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4770312-1206
UT
Other
Enumeration date
05/02/2007
Last updated
01/19/2017
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