Dominique Sage Elder

NPI #1063079705 in Provo, Utah

Provider Information

NPI Number: 1063079705
Entity Type: Individual
Name: Dominique Sage Elder
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: May 28, 2019
Last Updated: Jul 30, 2025

Practice Location

Address: 1800 S NOVELL PLACE
City: Provo
State: Utah
ZIP Code: 84606
Phone: (801) 830-2038

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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