Individual
LAUREN WASSEL VITALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8213 S WILSON ST, MIDVALE, UT 84047-7555
(770) 540-7042
Mailing address
8213 S WILSON ST, MIDVALE, UT 84047-7555
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
14181669-1206
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/10/2023
Last updated
12/08/2025
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