Individual
BRYCE ALLAN LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1113 MERRILL HALL, PROVO, UT 84602-8337
(801) 839-5288
Mailing address
500A KMBL, PROVO, UT 84602-4704
(801) 839-5288
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
UT011486901256
UT
Other
Enumeration date
08/05/2024
Last updated
08/05/2024
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