Individual
KENNETH R. KOFOED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1660 W ANTELOPE DR, SUIT 115, LAYTON, UT 84041-1156
(801) 771-3024
Mailing address
PO BOX 786, LAYTON, UT 84041-0786
(801) 771-3024
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
7423
UT
Other
Enumeration date
11/02/2006
Last updated
07/08/2007
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