Individual
MADISEN JO AFFLECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4403 HARRISON BLVD STE 2600, OGDEN, UT 84403-3277
(801) 378-7450
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
14219864-1206
UT
Other
Enumeration date
10/11/2021
Last updated
02/06/2026
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