Individual
ALICIA BRUNNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8 TH AVE & C ST, SALT LAKE CITY, UT 84143-0001
(801) 408-1100
Mailing address
8 TH AVENUE & C ST, SALT LAKE CITY, UT 84143-0001
(801) 408-1100
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7232172-1206
UT
363AM0700X
Medical Physician Assistant
PA156580
OR
Other
Enumeration date
02/20/2009
Last updated
03/19/2014
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