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Organization

UTAH STATE HOSPITAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ANDREW NICHOLS PH.D. (NEUROPSYCHOLOGIST)
(801) 344-4331
Entity
Organization

Contact information

Practice address
1300 E CENTER ST, PROVO, UT 84606-3554
(801) 344-4331
Mailing address
1300 E CENTER ST, PROVO, UT 84606-3554

Taxonomy

Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
8651960-2501
UT

Other

Enumeration date
02/10/2014
Last updated
02/10/2014
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