Individual
DRAKE ALVIN KAPONO NERVEZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
344 EAST 100 SOUTH, STE 301, SALT LAKE CITY, UT 84111
(801) 322-4257
Mailing address
3822 S CLARE DR, C4, WEST VALLEY CITY, UT 84119-5773
(808) 987-9459
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
09/01/2016
Last updated
09/01/2016
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