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1043040199
BRYCE ALLAN LEWIS
PROVO, UT
NPI
1043040199
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: UT UT011486901256)
Enumeration Date
2024-08-05
Last Update Date
2024-08-05
Business Address
BRYCE ALLAN LEWIS
1113 MERRILL HALL
PROVO, UT 84602-8337
Phone number: 801-839-5288
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Mailing Address
BRYCE ALLAN LEWIS
500A KMBL
PROVO, UT 84602-4704
Phone number: 801-839-5288
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