Individual
SPENCER PILI LAULUSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1055 N 500 W, PROVO, UT 84604-3305
(801) 373-7350
Mailing address
1055 N 500 W, ATTN CREDENTIALING, PROVO, UT 84604
(801) 354-8225
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
12456226-1206
UT
Other
Enumeration date
04/16/2021
Last updated
03/27/2026
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