US Air Force

NPI #1619145455 in Provo, Utah

Provider Information

NPI Number: 1619145455
Entity Type: Organization
Organization Name: US Air Force
Primary Specialty: Military Hospital
Enumeration Date: Feb 14, 2008
Last Updated: Feb 14, 2008

Practice Location

Address: 831 W 1280 S
City: Provo
State: Utah
ZIP Code: 84601-6518
Phone: (801) 373-9947

Authorized Official

Name: DAVID JASON CASSAT, MD
Title: FAMLIY PRACTICE
Phone: (801) 373-9947

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Military Hospital	286500000X	Primary

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