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1336219906
KENT BLAD
PROVO, UT
NPI
1336219906
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LP0200X Nurse Practitioner, Pediatrics
(Licence: UT 217117-4405)
Enumeration Date
2006-11-09
Last Update Date
2011-10-19
Business Address
-- KENT BLAD FNP
1675 N FREEDOM BLVD BLDG 3
PROVO, UT 84604-2540
Phone number: 801-377-8000
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Mailing Address
-- KENT BLAD FNP
1675 N FREEDOM BLVD BLDG 3
PROVO, UT 84604-2540
Phone number: 801-377-8000
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