IndividualActive
Aaron Provance, MD
NPI 1710024005 · Pediatric Sports Medicine Physician · Salt Lake City, UT
Provider details
- NPI number
- 1710024005
- Entity type
- Individual
- Primary specialty
- Pediatric Sports Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- DR.0044594 (CO)
Practice location
590 S Wakara Way
Salt Lake City, UT 84108-7106
Phone: (801) 587-7109
Mailing address
590 S Wakara Way
Salt Lake City, UT 84108
Registry dates
- Enumerated
- 2007-01-30
- Last updated
- 2023-06-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.