Laurie Melissa Centeno, PAC

NPI #1093088445 in Provo, Utah

Provider Information

NPI Number: 1093088445
Entity Type: Individual
Name: Laurie Melissa Centeno, PAC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PAC
Enumeration Date: Feb 15, 2012
Last Updated: Aug 22, 2016

Practice Location

Address: 1157 N 300 W STE 201
City: Provo
State: Utah
ZIP Code: 84604-6124
Phone: (801) 357-1200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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