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1578082061
SHANE G ELLIOTT
MIDVALE, UT
NPI
1578082061
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2017-09-15
Last Update Date
2022-07-21
Business Address
SHANE G ELLIOTT
7434 S STATE ST
MIDVALE, UT 84047-2014
Phone number: 801-456-9955
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Mailing Address
SHANE G ELLIOTT
7434 S STATE ST
MIDVALE, UT 84047-2014
Phone number: 801-456-9955
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