RANDAL N ELLSWORTH

PROVO, UT
NPI1588635627
Entity TypeIndividual
GenderMale
Sole Proprietor ?
Primary Taxonomy174400000X Specialist
(Licence: UT  942742051205)
Enumeration Date2006-01-27
Last Update Date2007-07-08
Business Address
DR. RANDAL N ELLSWORTH MD
1735 N STATE ST
PROVO, UT 84604-1010
Phone number: 801-374-1818
Mailing Address
DR. RANDAL N ELLSWORTH MD
510 W 650 S
OREM, UT 84058-6136
Phone number: 801-225-1717
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