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1740635556
ETHAN PATRICK BAHAM
LAYTON, UT
NPI
1740635556
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: UT 11217835-1204)
Enumeration Date
2016-04-29
Last Update Date
2019-07-01
Business Address
ETHAN PATRICK BAHAM DO
2121 N 1700 W
LAYTON, UT 84041-8803
Phone number: 801-773-4840
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Mailing Address
ETHAN PATRICK BAHAM DO
PO BOX 337
LAYTON, UT 84041-0337
Phone number: 801-773-4840
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