Individual
MR. ROBERT CRAIG SACCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FAAA, AUD
Contact information
Practice address
39 PROFESSIONAL WAY STE 1, PAYSON, UT 84651
(801) 465-4805
(801) 465-4354
Mailing address
1055 N 500 W, ATTN: CREDENTIALING, PROVO, UT 84604-3305
(801) 354-8225
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
107684-4101
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
U000094106
MEDICARE GROUP PTAN
UT
01
—
U000094166
MEDICARE PTAN
UT
Enumeration date
01/18/2007
Last updated
08/01/2018
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