Whalio Doctors

NPI 1235425109

Curtis Bryant Blackham

Practitioner Substance Abuse Rehabilitation Facility Moroni, UT

Practice location

Address
21260 N 1450 E, Moroni, UT 84646-0461
Phone
(435) 445-5200
Fax
(435) 445-5201
Mailing address
PO Box 461 21260 N 1450 E, Moroni, UT 84646-0461

Registered specialties

Substance Abuse Rehabilitation Facility Primary
Residential Treatment Facilities Taxonomy 324500000X Licence 272503815 (UT)

Registry record

NPI
1235425109
Entity type
Individual
Sex (as registered)
Male
NPI issued
20 Jun 2011
Record last updated
20 Jun 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.