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Individual

BRIAN TYLER MELVILLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
3945 WASHINGTON BLVD STE A, OGDEN, UT 84403-1825
(801) 479-4105
Mailing address
4403 HARRISON BLVD STE 3875, OGDEN, UT 84403-3332
(801) 387-7950

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
76705991204
UT

Other

Enumeration date
06/17/2015
Last updated
07/07/2022
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