Individual
OFA HAFOKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
750 N FREEDOM BLVD, PROVO, UT 84601-1677
(801) 373-4760
(801) 373-0639
Mailing address
750 N FREEDOM BLVD, PROVO, UT 84601-1677
(801) 373-4760
(801) 373-0639
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/02/2016
Last updated
05/02/2016
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