Individual
BRENT WALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1600 W ANTELOPE DR, LAYTON, UT 84041-1142
(801) 807-1000
Mailing address
2082 HUNTERS GLN, LAYTON, UT 84040-3154
(931) 809-0285
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
2491
TN
207L00000X
Anesthesiology Physician
Primary
343220-1204
UT
Other
Enumeration date
02/12/2007
Last updated
08/08/2023
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