Individual
WILLIAM BRENT EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1244 NO MAIN ST, STE201, TOOELE, TN 84074
(435) 882-3968
(435) 882-3859
Mailing address
1244 NO MAIN ST, STE201, TOOELE, TN 84074
(435) 882-3968
(435) 882-3859
Taxonomy
Speciality
Code
Description
License number
State
146D00000X
Personal Emergency Response Attendant
Primary
274737-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
52898551002
—
UT
Enumeration date
05/24/2006
Last updated
03/19/2020
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