US AIR FORCE

PROVO, UT
NPI1619145455
Entity TypeOrganization
Authorized ContactDAVID JASON CASSAT
Famliy Practice
801-373-9947
Organization Subpart ?No
Primary Taxonomy286500000X Military Hospital
(Licence: UT  590260-1205)
Enumeration Date2008-02-14
Last Update Date2008-02-14
Business Address
US AIR FORCE
831 W 1280 S
PROVO, UT 84601-6518
Phone number: 801-373-9947
Mailing Address
US AIR FORCE
831 W 1280 S
PROVO, UT 84601-6518
Phone number: