Brigham Young University

NPI #1215027099 in Provo, Utah

Provider Information

NPI Number: 1215027099
Entity Type: Organization
Organization Name: Brigham Young University
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Oct 13, 2006
Last Updated: Jul 21, 2022

Practice Location

Address: 1130 SFH SPORTS MED
City: Provo
State: Utah
ZIP Code: 84602
Phone: (801) 377-6918

Authorized Official

Name: MICHAEL KING
Title: ASSOCIATE ATHLETIC DIRECTOR/CONTROL
Phone: (801) 422-2098

Specialties & Taxonomy Codes

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

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