Individual
SHALIA HARTVIGSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1210 N 100 E, LAYTON, UT 84041-2425
(520) 609-5808
Mailing address
1210 N 100 E, LAYTON, UT 84041-2425
(520) 609-5808
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
12029227-1206
UT
Other
Enumeration date
11/24/2020
Last updated
11/24/2020
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