Individual
LAURIE DEADMOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
151 S UNIVERSITY AVE, PROVO, UT 84601-4427
(801) 851-7058
Mailing address
151 S UNIVERSITY AVE, PROVO, UT 84601-4427
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
5858528-3102
UT
Other
Enumeration date
07/22/2019
Last updated
07/22/2019
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