Provider Demographics
NPI:1487627832
Name:BRIGGS, GARY EUGENE (ATC, PES)
Entity Type:Individual
Prefix:MR
First Name:GARY
Middle Name:EUGENE
Last Name:BRIGGS
Suffix:
Gender:M
Credentials:ATC, PES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3077 SWEET CLOVER LN
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-3395
Mailing Address - Country:US
Mailing Address - Phone:801-302-1007
Mailing Address - Fax:
Practice Address - Street 1:301 W SOUTH TEMPLE
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84101-1216
Practice Address - Country:US
Practice Address - Phone:801-325-2527
Practice Address - Fax:801-325-2529
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/Technologist