Healthcare Provider Details

I. General information

NPI: 1255872560
Provider Name (Legal Business Name): BRYCE KENNETH GALBRAITH DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2017
Last Update Date: 09/01/2023
Certification Date: 08/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 S 3000 W
WEST POINT UT
84015-7414
US

IV. Provider business mailing address

PO BOX 5546
DENVER CO
80217-5546
US

V. Phone/Fax

Practice location:
  • Phone: 801-475-3960
  • Fax: 801-475-3961
Mailing address:
  • Phone: 801-475-3500
  • Fax: 801-475-3489

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number12486406-1204
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: