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Individual

MR. ERICK FARR HENNESSY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
2390 S REDWOOD RD, SALT LAKE CITY, UT 84119-2027
(801) 975-1600
Mailing address
2390 S REDWOOD RD, SALT LAKE CITY, UT 84119-2027
(801) 975-1600

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
6932179-1206

Other

Enumeration date
09/22/2010
Last updated
02/10/2012
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