SHANE POULSEN

PLEASANT GROVE, UT
NPI1710247788
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy172V00000X Community Health Worker
Enumeration Date2012-05-23
Last Update Date2012-05-23
Business Address
-- SHANE POULSEN
1344 W STATE RD
PLEASANT GROVE, UT 84062-5022
Phone number: 801-785-8870
Mailing Address
-- SHANE POULSEN
1344 W STATE RD
PLEASANT GROVE, UT 84062-5022
Phone number: 801-785-8870