Individual
BRADLEY WAYNE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1355 N UNIVERSITY AVE, #210, PROVO, UT 84604-2721
(801) 373-8930
(801) 377-6811
Mailing address
1355 N UNIVERSITY AVE, #210, PROVO, UT 84604-2721
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
5579883-1205
UT
Other
Enumeration date
05/01/2006
Last updated
10/26/2011
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