Individual
JOSHUA LEWIS CROCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1157 N 300 W STE 201, PROVO, UT 84604-6124
(801) 357-1200
Mailing address
1055 N 500 W, ATT CREDENTIALING, PROVO, UT 84604
(801) 354-8225
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
12254634-1206
UT
Other
Enumeration date
04/26/2021
Last updated
07/17/2025
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