Individual
MR. BYRON J MOULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AUDIOLOGIST
Contact information
Practice address
1034 N 500 W, PROVO, UT 84604-3380
(801) 373-7850
(801) 357-7997
Mailing address
PO BOX 30180, SALT LAKE CITY, UT 84130-0180
(801) 357-7475
(801) 357-7997
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
57266144101
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
57266144101
UTAH STATE LICENSE
UT
Enumeration date
07/25/2006
Last updated
07/08/2007
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