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1689142440
BRIAN TODD SPENCER
PROVO, UT
NPI
1689142440
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: UT 9155350-1206)
Enumeration Date
2018-11-08
Last Update Date
2018-11-08
Business Address
BRIAN TODD SPENCER PA-C
1034 N 500 W
PROVO, UT 84604-3380
Phone number: 801-357-8586
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Mailing Address
BRIAN TODD SPENCER PA-C
6325 W 10150 N
HIGHLAND, UT 84003-3453
Phone number: 801-850-2071
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