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1770303158
MICAH THOMAS BUSH
PROVO, UT
NPI
1770303158
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2024-10-11
Last Update Date
2024-10-11
Business Address
MICAH THOMAS BUSH
750 N FREEDOM BLVD STE 300
PROVO, UT 84601-1690
Phone number: 801-373-4760
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Mailing Address
MICAH THOMAS BUSH
750 N FREEDOM BLVD STE 300
PROVO, UT 84601-1690
Phone number: 801-373-4760
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