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1023569241
MICHAEL ANDERSON
PROVO, UT
NPI
1023569241
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: UT 10117275-1206)
Enumeration Date
2016-10-24
Last Update Date
2021-09-23
Business Address
MICHAEL ANDERSON PA
1055 N 500 W STE 101
PROVO, UT 84604-3305
Phone number: 801-373-4366
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Mailing Address
MICHAEL ANDERSON PA
1055 N 500 W ATTN: CREDENTIALING
PROVO, UT 84604-3305
Phone number: 801-354-8225
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