Ebrainmd, LLC

NPI #1811167547 in Bountiful, Utah

Provider Information

NPI Number: 1811167547
Entity Type: Organization
Organization Name: Ebrainmd, LLC
Primary Specialty: Specialist
Enumeration Date: Mar 10, 2008
Last Updated: Apr 14, 2016

Practice Location

Address: 3401 S HIGHWAY 89
City: Bountiful
State: Utah
ZIP Code: 84010-8517
Phone: (801) 295-2438

Authorized Official

Name: DR. BRENT LEE CLYDE, M.D.
Title: OWNER
Phone: (801) 295-2438

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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