Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | 5552450-1205 | UT |
NPI | 1093820706 |
---|---|
Provider Name | David W Brinton |
First Address | Salt Lake City, UT 84127-0128 |
Second Address | Riverton, UT 84065-7217 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2006 |
Last Update Date | 26/06/2009 |