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3355 N University Ave Ste 250 Provo UT 84604-6640 | |
| (385) 312-9844 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 3355 N University Ave Ste 250, Provo, Utah |
| Authorized Official Name and Position | Anthony Allen Hughes (OWNER) |
| Authorized Official Contact | 3853129844 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3355 N University Ave Ste 250 Provo UT 84604-6640 Ph: (385) 312-9844 | 3355 N University Ave Ste 250 Provo UT 84604-6640 Ph: (385) 312-9844 |
| NPI Number | 1134514169 |
|---|---|
| Provider Enumeration Date | 04/06/2015 |
| Last Update Date | 09/29/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134514169 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 356326-3902 (Utah) | Primary |
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