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1396255360
BERNARD M MUTIE
DRAPER, UT
NPI
1396255360
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LG0600X Nurse Practitioner, Gerontology
(Licence: UT 79878114405)
Enumeration Date
2017-10-04
Last Update Date
2020-06-11
Business Address
BERNARD M MUTIE APRN
12433 S FORT ST
DRAPER, UT 84020-9363
Phone number: 801-576-1086
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Mailing Address
BERNARD M MUTIE APRN
5505 S 900 E
HOLLADAY, UT 84117-7209
Phone number: 801-783-5011
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