Individual
MS. KIMBERLY DAWN HAYCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1303 N MAIN ST, CEDAR CITY, UT 84721-9746
(435) 868-5251
Mailing address
PO BOX 30180, SALT LAKE CITY, UT 84130-0180
(485) 590-1124
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5170865-1206
UT
Other
Enumeration date
06/23/2006
Last updated
10/10/2016
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