Individual
RANDALL ROLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1300 E CENTER ST, PROVO, UT 84606
(801) 344-4400
Mailing address
PO BOX 270, PROVO, UT 84603-0270
(801) 344-4400
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
10834808-1205
UT
Other
Enumeration date
05/25/2006
Last updated
02/28/2020
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