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1437874401
ALLI BASCOM
PROVO, UT
NPI
1437874401
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: UT 8536735-4405)
Enumeration Date
2022-10-11
Last Update Date
2024-07-16
Business Address
Mrs. ALLI BASCOM APRN
3585 N UNIVERSITY AVE STE 250
PROVO, UT 84604-6622
Phone number: 801-459-7147
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Mailing Address
Mrs. ALLI BASCOM APRN
355 S 1200 W
OREM, UT 84058-5150
Phone number: 801-358-2149
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