Individual
JUAN CARLOS FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
58 S 950 W, BRIGHAM CITY, UT 84302-4424
(435) 538-5061
(435) 538-5066
Mailing address
PO BOX 526, BRIGHAM CITY, UT 84302-0526
(435) 538-5061
(435) 538-5066
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/19/2011
Last updated
05/19/2011
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