Individual
JAMES E CARLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
280 W RIVERPARK DR STE 120, PROVO, UT 84604
(801) 229-2011
Mailing address
258 S 810 E, SALEM, UT 84653-4001
(801) 471-3405
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5354572-1206
UT
Other
Enumeration date
12/09/2010
Last updated
03/04/2011
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