Individual
BRADY MONTE HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
475 W 940 N, PROVO, UT 84604-3301
(801) 357-7930
Mailing address
839 E 900 S, OREM, UT 84097-6611
(801) 369-5838
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
12374897-1204
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/20/2020
Last updated
04/12/2022
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