Individual
MICHAEL J CROOKSTON I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5770 S 1500 W, BLDG C, TAYLORSVILLE, UT 84123-5216
(801) 265-3049
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
166921-1205
UT
Other
Enumeration date
10/02/2006
Last updated
11/17/2010
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