Individual
CARSON HOMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1715 S 40 W, OREM, UT 84058-8409
(801) 661-3098
Mailing address
1715 S 40 W, OREM, UT 84058-8409
(801) 661-3098
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7625522-1206
UT
363A00000X
Physician Assistant
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/25/2020
Last updated
02/02/2021
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