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1467753434
REX CRAIG BROADBENT
SALT LAKE CITY, UT
NPI
1467753434
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: UT 6888110-6005)
Enumeration Date
2010-11-08
Last Update Date
2010-11-08
Business Address
Mr. REX CRAIG BROADBENT CSAC
411 GRANT ST
SALT LAKE CITY, UT 84116-2725
Phone number: 801-359-8862
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Mailing Address
Mr. REX CRAIG BROADBENT CSAC
411 GRANT ST
SALT LAKE CITY, UT 84116-2725
Phone number: 801-359-8862
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