Individual
KIP ALLAN LANDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSWI
Contact information
Practice address
750 N 200 W, PROVO, UT 84601-1677
(801) 373-4760
Mailing address
750 N 200 W, PROVO, UT 84601-1677
(801) 373-4760
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
70079313-3501
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/05/2008
Last updated
01/26/2017
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