Provider Demographics
NPI:1477072015
Name:GRIER, BRIAN (MPAS)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:GRIER
Suffix:
Gender:M
Credentials:MPAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 30079
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84130-0079
Mailing Address - Country:US
Mailing Address - Phone:801-375-8858
Mailing Address - Fax:801-429-8180
Practice Address - Street 1:1184 E 80 N
Practice Address - Street 2:
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-2906
Practice Address - Country:US
Practice Address - Phone:801-763-3885
Practice Address - Fax:801-763-3887
Is Sole Proprietor?:No
Enumeration Date:2017-09-14
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10516534-1206363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant