Individual
TIFFINY GREGORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
404 S 400 W, SALT LAKE CITY, UT 84101-2201
(801) 364-0058
(801) 364-0161
Mailing address
404 S 400 W, SALT LAKE CITY, UT 84101-2201
(801) 364-0058
(801) 364-0161
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2827628002
UT
Other
Enumeration date
03/27/2012
Last updated
03/27/2012
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