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Individual

BRYAN THOMAS BEALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
32 W WINCHESTER ST STE 101, SALT LAKE CITY, UT 84107-5609
(801) 263-6367
Mailing address
641 W 1290 N, LEHI, UT 84043-2327
(801) 664-6755
(602) 735-3405

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
07/23/2012
Last updated
07/23/2012
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