Individual
SUSANNA BENAVIDEZ CHAPMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
4745 S 3200 W, TAYLORSVILLE, SALT LAKE CITY, UT 84118-2822
(801) 964-6214
Mailing address
4745 S 3200 W, TAYLORSVILLE, SALT LAKE CITY, UT 84118-2822
(801) 964-6214
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
7796308-1206
UT
Other
Enumeration date
11/03/2010
Last updated
11/03/2010
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