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Organization
BRIGHAM YOUNG UNIVERSITY
Active
Organization
BRIGHAM YOUNG UNIVERSITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL KING (ASSOCIATE ATHLETIC DIRECTOR/CONTROL)
(801) 422-2098
Entity
Organization
Contact information
Practice address
1130 SFH SPORTS MED, PROVO, UT 84602
(801) 377-6918
(801) 377-6919
Mailing address
1130 SFH SPORTS MED, PROVO, UT 84602
(801) 377-6918
(801) 377-6919
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
UT
Other
Enumeration date
10/13/2006
Last updated
07/21/2022
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