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1255105995
BRIAN BRAD FERNCASE
SALT LAKE CITY, UT
NPI
1255105995
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2023-11-13
Last Update Date
2023-11-13
Business Address
BRIAN BRAD FERNCASE
117 W 400 S
SALT LAKE CITY, UT 84101-1916
Phone number: 801-428-4257
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Mailing Address
BRIAN BRAD FERNCASE
117 W 400 S
SALT LAKE CITY, UT 84101-1916
Phone number: 801-428-4257
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