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AOULIULIFOLAU MELE TAVITA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
714 S STATE ST, OREM, UT 84058-6366
(801) 666-4792
Mailing address
320 E CENTER ST, PROVO, UT 84606-3204
(951) 283-4679

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
7524698-3101
UT

Other

Enumeration date
06/07/2021
Last updated
06/07/2021
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