Individual
ETHAN MICHAEL YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
3723 W 12600 S STE 430, RIVERTON, UT 84065-7310
(801) 285-4200
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 706-1152
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
12384125-1206
UT
363AM0700X
Medical Physician Assistant
—
—
Other
Enumeration date
12/30/2018
Last updated
04/12/2022
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