IndividualActive
Brent Mains
NPI 1750079547 · Physician Assistant · Alpine, UT
Provider details
- NPI number
- 1750079547
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Male
- Sole proprietor
- Yes
- License
- 14277457-1206 (UT)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
833 E Coventry Ln
Alpine, UT 84004-1240
Phone: (385) 447-7929
Approximate (ZIP-level) locationGet directions
Mailing address
833 E Coventry Ln
Alpine, UT 84004-1240
Registry dates
- Enumerated
- 2023-04-28
- Last updated
- 2026-03-25
- Certified
- 2026-03-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.