Individual
MCKENZIE CARTER KENNINGTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5704 S 950 E, SOUTH OGDEN, UT 84405-4983
(801) 791-6819
Mailing address
PO BOX 337, LAYTON, UT 84041-0337
(801) 773-4840
(801) 525-8151
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11930257-1206
UT
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
06/15/2020
Last updated
01/18/2021
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