Individual
KELLY MARIE DALY-WOLFE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C, RDN
Contact information
Practice address
750 N 200 W, PROVO, UT 84601-1677
(801) 429-2000
Mailing address
589 S STATE ST, PROVO, UT 84606-5056
(801) 429-2000
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
8423560-1206
UT
Other
Enumeration date
09/05/2017
Last updated
05/20/2024
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