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Individual

TYRA POMAZAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
659 N 700 E, PROVO, UT 84606-6921
(530) 526-3935
Mailing address
659 N 700 E, PROVO, UT 84606-6921

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Enumeration date
02/03/2011
Last updated
02/03/2011
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  • Eligibility checks
  • EDI platform