Graduated: 1997
NPI: 1740274299
Practice Locations (4)
306 RIVER BEND LN
PROVO, UT 846045625
8012265838
1200 E 3900
SALT LAKE CITY, UT 841241300
8012936800
8074 S 1300
SANDY, UT 840940743
8015613400
5825 HARRISON BLVD
SOUTH OGDEN, UT 844034316
8014755254
Source: CMS National Downloadable File, September 2026.