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1154628311
BRADY PAUL PETERSEN
BRIGHAM CITY, UT
NPI
1154628311
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
253J00000X Foster Care Agency
Enumeration Date
2011-02-23
Last Update Date
2011-02-23
Business Address
Mr. BRADY PAUL PETERSEN
862 S MAIN ST #4
BRIGHAM CITY, UT 84302-3320
Phone number: 435-723-1795
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Mailing Address
Mr. BRADY PAUL PETERSEN
862 S MAIN ST #4
BRIGHAM CITY, UT 84302-3320
Phone number: 435-723-1795
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