Individual
SYDNEY FONTAINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
30 N 1900 E # 3B400, SALT LAKE CITY, UT 84132-0002
(801) 581-7719
Mailing address
30 N 1900 E # 3B400, SALT LAKE CITY, UT 84132-0002
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
12919118-1206
UT
Other
Enumeration date
08/19/2022
Last updated
12/03/2022
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