Individual
ANNE GRY WHEATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
363 E EDITH AVE, SALT LAKE CITY, UT 84111-4706
(253) 341-3390
Mailing address
375 S CHIPETA WAY, SALT LAKE CITY, UT 84108-1260
(253) 341-3390
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11480900-1206
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/08/2018
Last updated
12/17/2021
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