Individual
MR. PHILLIP JAMES ADRIAN HARTOG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1143 SMITH FIELDHOUSE, PROVO, UT 84602
(801) 422-4828
Mailing address
1143 SMITH FIELDHOUSE, PROVO, UT 84602-2246
(801) 422-4828
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
9903810-4810
UT
Other
Enumeration date
07/28/2017
Last updated
07/21/2022
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