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1376084772
KENT FULLMER
SALT LAKE CITY, UT
NPI
1376084772
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2017-03-17
Last Update Date
2017-03-17
Business Address
KENT FULLMER
344 E 100 S STE 301
SALT LAKE CITY, UT 84111-1727
Phone number: 801-428-3402
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Mailing Address
KENT FULLMER
1533 E 6670 S
SALT LAKE CITY, UT 84121-2773
Phone number:
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