Sierra Braithwaite
Specialist in Riverton, UT. Individual provider (NPI-1).
NPI number1124477906
StatusActive
Last updated in NPPESJun 13, 2016
Details
- NPI
- 1124477906
- Entity type
- Individual (NPI-1)
- Name
- Sierra Braithwaite
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 13, 2016
- Last updated
- Jun 13, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | 196587943 | UT | Yes |
Practice location
13923 S Haystack Peak CirRiverton, UT 84096-6453
Phone 801-506-6695
Mailing address
13923 S Haystack Peak CirRiverton, UT 84096-6453
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