Individual
KELSEY THORNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2245 N 400 E STE 201, LOGAN, UT 84341-1891
(435) 787-7001
(801) 216-8357
Mailing address
2245 N 400 E STE 201, LOGAN, UT 84341-1891
(435) 787-7001
(801) 216-8357
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
13633355
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13633355-1206
STATE LICENSE
UT
Enumeration date
05/26/2018
Last updated
10/20/2023
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