Individual
GARY HEASTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
7238 6TH ST, JENSEN OCCUPATIONAL MEDICINE CENTER, BLDG. 249, HILL AIR FORCE BASE, UT 84056-5213
(801) 777-1157
Mailing address
JENSEN OCCUPATIONAL MEDICAL CENTER, 7238 6TH ST. BLDG 249, HILL AIR FORCE BASE, UT 84056-5213
(801) 777-1157
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
324779-1206
UT
Other
Enumeration date
05/02/2006
Last updated
05/07/2025
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