Individual
TRESS SOPHIA KEOGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3723 S 645 E, SALT LAKE CITY, UT 84106-1147
(704) 999-8743
Mailing address
3723 S 645 E, SALT LAKE CITY, UT 84106-1147
(704) 999-8743
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
13030982-1206
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
STUDENT
—
Enumeration date
08/02/2022
Last updated
05/02/2023
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