Individual
ELISA RENE WILCOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
440 W 200 S, SUITE 250, SALT LAKE CITY, UT 84101-1345
(801) 595-1600
Mailing address
440 W 200 S, SUITE 250, SALT LAKE CITY, UT 84101-1345
(801) 595-1600
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
343333-1206
UT
Other
Enumeration date
07/28/2008
Last updated
07/28/2008
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