Individual
MATTHEW R LOVELACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
173 N 400 W STE C11, OREM, UT 84057-1909
(801) 802-7373
(801) 802-7733
Mailing address
1055 N 500 W, ATTN: CREDENTIALING, PROVO, UT 84604
(801) 354-8225
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10497014-1206
UT
Other
Enumeration date
08/31/2017
Last updated
11/27/2023
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