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Individual

KODY R CROWELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1268 W SOUTH JORDAN PKWY STE 201, #201, SOUTH JORDAN, UT 84095-4653
(801) 254-9700
Mailing address
14256 S SOLEMN WAY, HERRIMAN, UT 84096-3584
(435) 760-3619

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
84364811205
UT

Other

Enumeration date
05/11/2011
Last updated
04/27/2017
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