Paul Kenneth Brimley

Individual provider Active NPI Foster Care Agency · Spanish Fork, UT

NPI 1992018972 · NPPES record last updated Jul 15, 2014

Key facts

NPI
1992018972
Entity type
Individual (NPI type 1)
Primary specialty
Foster Care Agency 253J00000X
Practice address
704 N State Road 51
Spanish Fork, UT 84660-1385
Phone
(801) 794-0318
Fax
(801) 794-9514
NPI assigned
Jul 20, 2010
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Foster Care Agency 253J00000X Yes

Addresses

Primary practice location

704 N State Road 51
Spanish Fork, UT 84660-1385

Mailing address

704 N State Road 51
Spanish Fork, UT 84660-1385
Phone (801) 794-0318

Other providers in Spanish Fork, UT

All providers in Spanish Fork, UT · Foster Care Agency in Utah

Sources for this page

Verify at the official NPI Registry.