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1104317627
BENNETT JOSEPH CHARGO
PROVO, UT
NPI
1104317627
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
231H00000X Audiologist
(Licence: UT 10834959-4101)
Enumeration Date
2018-05-21
Last Update Date
2018-05-21
Business Address
BENNETT JOSEPH CHARGO
1832 N 1120 W
PROVO, UT 84604-1179
Phone number: 801-495-4800
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Mailing Address
BENNETT JOSEPH CHARGO
1877 S 200 E APT 11
SALT LAKE CITY, UT 84115-2158
Phone number: 952-239-2754
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