Individual
MRS. LAURIE CHILDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
12340 S 450 E, DRAPER, UT 84020-8154
(801) 501-9797
Mailing address
12340 S 450 E, DRAPER, UT 84020-8154
(801) 501-9797
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
6492794-1206
UT
Other
Enumeration date
04/18/2007
Last updated
02/14/2017
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