DIRK BRADLEY BAHORAVITCH

PROVO, UT
NPI1184083826
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: ID  53485)
Enumeration Date2016-02-22
Last Update Date2021-01-19
Business Address
DIRK BRADLEY BAHORAVITCH MSN, CRNA
1067 N 500 W
PROVO, UT 84604-3305
Phone number: 801-374-0354
Mailing Address
DIRK BRADLEY BAHORAVITCH MSN, CRNA
264 N 1020 E
AMERICAN FORK, UT 84003-2957
Phone number: 801-592-5424
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