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1942437918
TRAVIS LEE DIMOND
PROVO, UT
NPI
1942437918
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: UT 7371008-1206)
Enumeration Date
2009-06-17
Last Update Date
2024-10-25
Business Address
TRAVIS LEE DIMOND PA-C
395 W COUGAR BLVD STE 803
PROVO, UT 84604-3311
Phone number: 801-235-7246
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Mailing Address
TRAVIS LEE DIMOND PA-C
PO BOX 27128
SALT LAKE CITY, UT 84127-0128
Phone number:
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