Individual
TROY W BITTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1157 N 300 W, #201, PROVO, UT 84604-6124
(801) 357-8898
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 357-8898
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
325429-1206
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32542912001001
BCBS OF UTAH
UT
01
—
P00129810
PALMETTO GBA
—
Enumeration date
06/01/2006
Last updated
06/15/2010
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