Individual
JOHN HUMPHREYS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
404 S 400 W, SALT LAKE CITY, UT 84101-2201
(801) 364-0058
Mailing address
318 WESTWOOD RD, PARK CITY, UT 84098-5607
(435) 649-7553
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
361599-1206 , 8906
UT
Other
Enumeration date
03/06/2007
Last updated
07/08/2007
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