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Individual

MR. MARK ERIC BEESE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ATC, LAT

Contact information

Practice address
590 S WAKARA WAY, SALT LAKE CITY, UT 84108-1200
(801) 587-1473
(801) 587-7115
Mailing address
580 WAKARA WAY, SALT LAKE CITY, UT 84108
(801) 587-1473
(801) 587-7115

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
7726414-4810
UT

Other

Enumeration date
02/03/2016
Last updated
02/03/2016
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