ALLI BASCOM

PROVO, UT
NPI1437874401
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner Family
(Licence: UT  8536735-4405)
Enumeration Date2022-10-11
Last Update Date2024-07-16
Business Address
MRS. ALLI BASCOM APRN
3585 N UNIVERSITY AVE STE 250
PROVO, UT 84604-6622
Phone number: 801-459-7147
Mailing Address
MRS. ALLI BASCOM APRN
355 S 1200 W
OREM, UT 84058-5150
Phone number: 801-358-2149
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