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Individual

LEVI ROBERT BACHLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PAC

Contact information

Practice address
360 S 1300 W, PLEASANT GROVE, UT 84062-3761
(385) 440-1400
(801) 845-9965
Mailing address
1887 AARON DR STE B, TOOELE, UT 84074-8138
(435) 884-3578
(435) 884-3582

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
4967076-1206
UT
363AM0700X
Medical Physician Assistant
PA828
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100502625
NV
05
100502639
NV
Enumeration date
01/23/2006
Last updated
09/14/2021
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