Individual
MR. JOSEPH SEAN MAYNARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APC
Contact information
Practice address
58 S 950 W, BRIGHAM CITY, UT 84302-4424
(435) 538-5061
Mailing address
PO BOX 526, BRIGHAM CITY, UT 84302-0526
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
7744640-6009
UT
Other
Enumeration date
05/05/2011
Last updated
05/05/2011
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