Individual
AMANDA C VAN GILS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1365 W 1000 N, SALT LAKE CITY, UT 84116-1654
(801) 328-5750
(801) 521-7463
Mailing address
1365 W 1000 N, SALT LAKE CITY, UT 84116-1654
(801) 328-5750
(801) 521-7463
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5742442-1206
UT
Other
Enumeration date
09/16/2008
Last updated
09/16/2008
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