TRAVIS VISSER

SPANISH FORK, UT
NPI1730503079
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: UT  84676436006)
Enumeration Date2014-02-06
Last Update Date2014-02-06
Business Address
-- TRAVIS VISSER
1237 E 150 S
SPANISH FORK, UT 84660-2371
Phone number: 435-705-3369
Mailing Address
-- TRAVIS VISSER
1237 E 150 S
SPANISH FORK, UT 84660-2371
Phone number: 435-705-3369