Most Relevant Information
Provider Data
| NPI Number: | 1003273061 |
| Provider Name: | ANTHONY BERSAMEN |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/21/2016 |
| Last Updated: | 01/21/2016 |
Provider Practice Location
991 WHITAKER DR
TOOELE
UT
840749483
Practice Location Phone/Fax
| Phone: | 4352248062 |
| Fax: |
Provider Mailing Location
991 WHITAKER DR
TOOELE
UT
840749483
Provider Mailing Phone/Fax
| Phone: | 4352248062 |
| Fax: |