Individual
BRANDON D PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
4700 HARRISON BLVD, OGDEN, UT 84403-4303
(801) 475-3300
(801) 475-3301
Mailing address
PO BOX 5546, DENVER, CO 80217-5546
(801) 475-3500
(801) 475-3414
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3749704405
UT
Other
Enumeration date
02/08/2006
Last updated
10/25/2024
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