Individual
DEVAN MICHAEL THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTITIONER
Contact information
Practice address
10011 S CENTENNIAL PKWY STE 350, SANDY, UT 84070-4137
(801) 566-5350
Mailing address
75 S 200 E, STE 100, PROVO, UT 84606-3146
(801) 877-5801
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
86565854405
UT
Other
Enumeration date
07/25/2017
Last updated
03/09/2020
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