Individual
AARON PROVANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
590 S WAKARA WAY, SALT LAKE CITY, UT 84108-7106
(801) 587-7109
Mailing address
590 S WAKARA WAY, SALT LAKE CITY, UT 84108
(801) 587-7109
Taxonomy
Speciality
Code
Description
License number
State
2080S0010X
Pediatric Sports Medicine Physician
Primary
12804185-1205
UT
2080S0010X
Pediatric Sports Medicine Physician
DR.0044594
CO
Other
Enumeration date
01/30/2007
Last updated
06/25/2023
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