Individual
MR. PATRICK BARDE LANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
7495 SOUTH. STATE STREET, MIDVALE, UT 84047
(801) 213-9400
Mailing address
7495 SOUTH. STATE STREET, MIDVALE, UT 84047
(801) 213-9400
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
377086-1206
UT DPOL PA
UT
01
—
377086-8906
UTAH DOPL PA CONTROL SUB
UT
01
—
TPRA08420
MOLINDA HEALTHCARE OF UT
UT
Enumeration date
12/09/2006
Last updated
11/03/2011
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