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1245080712
BRANDON LANE
SLC, UT
NPI
1245080712
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2024-03-26
Last Update Date
2024-03-26
Business Address
BRANDON LANE
1875 S REDWOOD RD
SLC, UT 84104-5112
Phone number: 801-363-9400
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Mailing Address
BRANDON LANE
1875 S REDWOOD RD
SLC, UT 84104-5112
Phone number:
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