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1427606128
SHANE POULSEN
OGDEN, UT
NPI
1427606128
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2019-08-27
Last Update Date
2019-08-27
Business Address
SHANE POULSEN
237 26TH ST
OGDEN, UT 84401-3105
Phone number: 801-625-3700
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Mailing Address
SHANE POULSEN
237 26TH ST
OGDEN, UT 84401-3105
Phone number:
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