Individual
BRADY GAGON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10298 S OTTER TRAIL DR, SOUTH JORDAN, UT 84009-6109
(801) 317-7996
Mailing address
10298 S OTTER TRAIL DR, SOUTH JORDAN, UT 84009-6109
(801) 317-7996
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/28/2024
Last updated
03/28/2024
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