Individual
MS. SHONTI G. BREISCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-1947
(801) 581-7606
Mailing address
6150 S VINEWAY CIR, MURRAY, UT 84121-1947
(801) 243-8165
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11439425-1206
UT
Other
Enumeration date
10/08/2018
Last updated
10/20/2022
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