Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | 293281-1205 | UT |
NPI | 1033373865 |
---|---|
Provider Name | Dr. Terrell Lee Sellers |
First Address | Orem, UT 84297 |
Second Address | Midway, UT 84049-6764 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2008 |
Last Update Date | 07/12/2017 |