Individual
MR. ALEXANDER GOUTTSOUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
30 N 1900 E, SALT LAKE CITY, UT 84132-0002
(801) 585-1935
(801) 587-5872
Mailing address
30 N 1900 E, SALT LAKE CITY, UT 84132-0002
(801) 265-2212
(801) 265-0103
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7776119-1206
UT
363AM0700X
Medical Physician Assistant
7776119-1206
UT
Other
Enumeration date
09/21/2010
Last updated
12/18/2024
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