| Organization Name: | BRIGHAM YOUNG UNIVERSITY |
| NPI Number: | 1215027099 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHAEL KING (ASSOCIATE ATHLETIC DIRECTOR/CONTROL) |
| Mailing Address: | 1130 Sfh Sports Med Provo |
| State: | UT US |
| Postal Code: | 84602 |
| Phone Number: | 8013776918 |
| Fax Number: | 8013776919 |
| NPI Enumeration Date: | 10/13/2006 |
| NPI Last Update Date: | 01/11/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 390200000X |
| License Number: | ========= |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Student, Health Care |
| Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |