Individual
MS. OLIVIA FISHER WALTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
500 FOOTHILL BLVD, MAIL CODE 112, SALT LAKE CITY, UT 84148-0001
(801) 582-1565
(801) 584-2587
Mailing address
346 PIERPONT AVE # 117, SALT LAKE CITY, UT 84101-1799
(801) 582-1565
(801) 584-2587
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
4767014-1206
UT
Other
Enumeration date
08/19/2006
Last updated
07/08/2007
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