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1750044103
GINA BANHAM
BRIGHAM CITY, UT
NPI
1750044103
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2021-10-21
Last Update Date
2021-10-21
Business Address
GINA BANHAM
60 S MAIN ST STE B0001
BRIGHAM CITY, UT 84302-6795
Phone number: 435-239-8768
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Mailing Address
GINA BANHAM
60 S MAIN ST STE B0001
BRIGHAM CITY, UT 84302-6795
Phone number:
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