| Trauma Center Of Utah, Llc | |
|
4980 N University Ave Apt 12 Provo UT 84604-6444 | |
| (801) 644-4014 | |
| Not Available |
| Full Name | Trauma Center Of Utah, Llc |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 4980 N University Ave Apt 12, Provo, Utah |
| Authorized Official Name and Position | Tonya Porter (CLINICAL DIRECTOR) |
| Authorized Official Contact | 8018515504 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Trauma Center Of Utah, Llc 4980 N University Ave Apt 12 Provo UT 84604-6444 Ph: (801) 644-4014 | Trauma Center Of Utah, Llc 4980 N University Ave Apt 12 Provo UT 84604-6444 Ph: (801) 644-4014 |
| NPI Number | 1295207231 |
|---|---|
| Provider Enumeration Date | 12/31/2018 |
| Last Update Date | 12/31/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295207231 | NPI | - | NPPES |
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