KENT BLAD

PROVO, UT
NPI1336219906
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363LP0200X Nurse Practitioner, Pediatrics
(Licence: UT  217117-4405)
Enumeration Date2006-11-09
Last Update Date2011-10-19
Business Address
-- KENT BLAD FNP
1675 N FREEDOM BLVD BLDG 3
PROVO, UT 84604-2540
Phone number: 801-377-8000
Mailing Address
-- KENT BLAD FNP
1675 N FREEDOM BLVD BLDG 3
PROVO, UT 84604-2540
Phone number: 801-377-8000
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