Individual
MRS. TAVIA MATHERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.P.R.N
Contact information
Practice address
3550 N UNIVERSITY AVE STE 250, PROVO, UT 84604-6685
(801) 374-9625
(801) 374-9690
Mailing address
3550 N UNIVERSITY AVE STE 250, PROVO, UT 84604-6685
(801) 374-9625
(801) 374-9690
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4738067-4408
UT
Other
Enumeration date
09/09/2008
Last updated
09/09/2008
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