Individual
CAMILLE ELIZABETH CROCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1130 SMITH FIELDHOUSE, PROVO, UT 84602-2246
(801) 422-2946
Mailing address
1130 SMITH FIELDHOUSE, PROVO, UT 84602-2246
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
11395933-4810
UT
Other
Enumeration date
09/03/2019
Last updated
09/03/2019
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