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1205672227
TANNER MOFFAT
PROVO, UT
NPI
1205672227
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: UT 14006549-3502)
Enumeration Date
2024-07-09
Last Update Date
2024-07-09
Business Address
TANNER MOFFAT
1869 N 1120 W
PROVO, UT 84604-1180
Phone number: 442-207-8625
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Mailing Address
TANNER MOFFAT
1046 E SCUTTLEBUTT LN
SARATOGA SPRINGS, UT 84045-5679
Phone number:
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