ANDREW JACOB ROUSH

PROVO, UT
NPI1780210062
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: UT  2000038169)
Enumeration Date2020-03-18
Last Update Date2020-03-18
Business Address
ANDREW JACOB ROUSH
226 E 400 N
PROVO, UT 84606-2914
Phone number: 801-725-8522
Mailing Address
ANDREW JACOB ROUSH
226E 400 NORTH
PROVO, UT 84606
Phone number: