NPI 1770390684
Eliza Mavis Anderson
Practice location
- Address
- 1001 N 500 W, Provo, UT 84604-3305
- Phone
- (801) 377-9661
- Mailing address
- 1460 E Shane Cir, Sandy, UT 84092-5939
Registered specialties
Recreation Therapist
Primary
Registry record
- NPI
- 1770390684
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 13 Dec 2024
- Record last updated
- 13 Dec 2024
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.