Individual
LARRY GLEN ANDREW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
746 E 1910 S STE 1, PROVO, UT 84606-6227
(801) 377-0580
(801) 375-5582
Mailing address
746 E 1910 S STE 1, PROVO, UT 84606-6227
(801) 377-0580
(801) 375-5582
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
326767-1204
UT
Other
Enumeration date
11/09/2006
Last updated
07/03/2013
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