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1508339466
KIM E THAYNE
PROVO, UT
NPI
1508339466
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
(Licence: UT 11079655-3503)
Enumeration Date
2019-01-03
Last Update Date
2019-01-03
Business Address
KIM E THAYNE
750 N FREEDOM BLVD
PROVO, UT 84601-1677
Phone number: 801-373-4760
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Mailing Address
KIM E THAYNE
750 N FREEDOM BLVD
PROVO, UT 84601-1677
Phone number: 801-373-4760
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