Individual
JUSTIN L. MELLOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2075 UNIVERSITY PARK BLVD, LAYTON, UT 84041-1611
(801) 786-7500
(801) 737-9531
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(480) 580-4452
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9428298-1204
UT
Other
Enumeration date
06/15/2010
Last updated
09/21/2021
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