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1710247788
SHANE POULSEN
PLEASANT GROVE, UT
NPI
1710247788
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2012-05-23
Last Update Date
2012-05-23
Business Address
-- SHANE POULSEN
1344 W STATE RD
PLEASANT GROVE, UT 84062-5022
Phone number: 801-785-8870
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Mailing Address
-- SHANE POULSEN
1344 W STATE RD
PLEASANT GROVE, UT 84062-5022
Phone number: 801-785-8870
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