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1710208848
BENJAMIN VIRLOW MOORE
PRICE, UT
NPI
1710208848
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: UT 6396608-3502)
Enumeration Date
2010-06-11
Last Update Date
2010-06-11
Business Address
-- BENJAMIN VIRLOW MOORE CSW
575 EAST 100 SOUTH
PRICE, UT 84501
Phone number: 435-637-2358
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Mailing Address
-- BENJAMIN VIRLOW MOORE CSW
PO BOX 867 105 WEST 100 NORTH
PRICE, UT 84501
Phone number: 435-637-7200
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