Individual
SHANE ANDREW BACKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
30 N 1900 E RM 3B110, SALT LAKE CITY, UT 84132-2101
(801) 581-8738
Mailing address
30 N 1900 E RM 3B110, SALT LAKE CITY, UT 84132-2101
(801) 581-8738
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
08/03/2015
Last updated
10/16/2021
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