Individual
MITCHELL DAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
900 ROUND VALLEY DR STE 100, PARK CITY, UT 84060-7552
(435) 655-6607
(435) 655-2388
Mailing address
900 ROUND VALLEY DR STE 100, PARK CITY, UT 84060-7552
(435) 655-6607
(435) 655-2388
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8772001206
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8772001206
MEDICAL
UT
01
—
PA60276
MEDICAL LICENSE
CA
Enumeration date
09/09/2021
Last updated
12/30/2025
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