NPI 1942276092

Brigham Young University

Organisation Point of Service Provo, UT

Practice location

Address: 1750 N Wymount Terrace Dr 2300, Provo, UT 84602-4800
Phone: (801) 422-2771
Fax: (801) 422-0764
Mailing address: 1750 N Wymount Terrace Dr 2300 Shc, Provo, UT 84602-4800

Authorised official

Name: D Keith Willmore
Title: Medical Director
Phone: (801) 422-7443

Registered specialties

Point of Service Primary

Managed Care Organizations Taxonomy 305S00000X

Other Point of Service providers in Utah →

Registry record

NPI: 1942276092
Entity type: Organization
NPI issued: 28 Feb 2006
Record last updated: 16 Jun 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.