Individual
BRENT D. MAINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
833 E COVENTRY LN, ALPINE, UT 84004-1240
(385) 447-7929
Mailing address
833 E COVENTRY LN, ALPINE, UT 84004-1240
(385) 447-7929
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
14277457-1206
UT
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/28/2023
Last updated
03/25/2026
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